Assay for B-galactosidase activity

ABSTRACT

The invention is directed to an assay for acid β-galactosidase activity. The invention may include combining in oil a sample droplet with a 4-methylumbelliferyl-B-galactose to yield a reaction droplet; splitting the reaction droplet to yield a first daughter droplet and a second daughter droplet; combining the first daughter droplet with a stop buffer droplet to yield a first stopped reaction droplet; incubating the second daughter droplet; combining the second daughter droplet with a stop buffer droplet to yield a second stopped reaction droplet; and measuring 4-methylumbelliferone released in the first and second stopped reaction droplets.

RELATED APPLICATIONS

This application is a continuation of and incorporates by reference U.S.patent application Ser. No. 13/738,259, entitled “Method of Conductingan Assay” having a filing date of Jan. 10, 2013, now U.S. Pat. No.8,592,217, the application of which is a continuation of andincorporates by reference U.S. patent application Ser. No. 13/305,820,entitled “Method of Hydrolyzing an Enzymatic Substrate” having a filingdate of Nov. 29, 2011, now U.S. Pat. No. 8,394,641, the application ofwhich is a continuation-in-part of and incorporates by reference U.S.patent application Ser. No. 12/531,844, entitled “Enzymatic Assays for aDroplet Actuator” filed on Feb. 26, 2010, now U.S. Pat. No. 8,440,392,the application of which claims priority to and incorporates byreference International Patent Application No. PCT/US2008/057959,entitled “Enzymatic Assays for a Droplet Actuator” International filingdate of Mar. 23, 2008, the application of which claims priority to andincorporates by reference related provisional U.S. Patent ApplicationNo. 60/896,341, entitled “Enzymatic Assays for a Droplet Microactuator”filed on Mar. 22, 2007; U.S. patent application Ser. No. 13/305,820 isalso a continuation of U.S. patent application Ser. No. 13/012,831,entitled “Enzymatic Assays Using Umbelliferone Substrates withCyclodextrins in Droplets in Oil,” filed Jan. 25, 2011, which is acontinuation of and incorporates by reference International Patent App.No. PCT/US2010/061118, entitled “Enzyme Assays on a Droplet Actuator”filed Dec. 10, 2010, the application of which claims priority to andincorporates by reference related provisional U.S. Patent Application61/288,633, entitled “MPS II Assay on a Droplet Actuator” filed on Dec.21, 2009; 61/290,296, entitled “Enzyme Assays on a Droplet Actuator”filed on Dec. 28, 2009; 61/325,580, entitled “Enzyme Assays on a DropletActuator” filed on Apr. 19, 2010; 61/334,376, entitled “Enzyme Assays ona Droplet Actuator” filed on May 13, 2010; 61/359,943, entitled “EnzymeAssays on a Droplet Actuator” filed on Jun. 30, 2010; 61/378,705,entitled “Enzyme Assays on a Droplet Actuator” filed on Aug. 31, 2010;61/382,564, entitled “Enzyme Assays on a Droplet Actuator” filed on Sep.14, 2010; 61/392,633, entitled “Enzyme Assays on a Droplet Actuator”filed on Oct. 13, 2010; and 61/406,380, entitled “Enzyme Assays on aDroplet Actuator” filed on Oct. 25, 2010. The disclosures of theaforementioned applications are specifically incorporated by referenceherein in their entireties.

GOVERNMENT INTEREST

This invention was made with government support under HD062316 awardedby the National Institutes of Health. The government has certain rightsin the invention.

The foregoing statement with respect to government support underHD062316 applies only to those aspects of the invention described andclaimed in this application arising out of U.S. Provisional PatentApplication No. 61/406,380, entitled “Enzyme Assays on a DropletActuator,” filed Oct. 25, 2010.

FIELD OF THE INVENTION

The invention generally relates to droplet actuator devices and assaymethods. In particular, the invention relates to droplet actuatordevices and enzymatic assays using umbelliferone substrates withcyclodextrins in droplets in oil.

BACKGROUND

A droplet actuator may include one or more substrates configured to forma surface or gap for conducting droplet operations. The one or moresubstrates establish a droplet operations surface or gap for conductingdroplet operations and may also include electrodes arrange to conductthe droplet operations. The droplet operations substrate or the gapbetween the substrates may be coated or filled with a filler fluid thatis immiscible with the liquid that forms the droplets.

Droplet actuators are used in a variety of applications, includingmolecular diagnostic assays, such as enzymatic assays and immunoassays.In one application, enzymatic assays and immunoassays are used as partof a routine testing process to test newborn infants for various geneticdisorders. For example, enzymatic assays may be used to test for variouslysosomal storage diseases (LSD), galactosemia and biotimidasedeficiency (BIOT) Immunoassays may be used to test for congenitalhypothyroidism (CH), congenital adrenal hyperplasia (CAH) and cysticfibrosis (CF). Current enzymatic assay and immunoassay technologies usedin newborn testing are based on 96-well microtiter plate compatiblesystems. Specimens are punched automatically from a neonatal dried bloodspot (DBS) sample into several plates (i.e., one punch for each test tobe performed) and each plate is manipulated according to a specificassay protocol. Each assay may require a separate laboratory sectionwith a manager, one or more technologists, and equipment dedicated tothe assay. Overall, the system is labor intensive (although one or moresteps are at least partially automated) and reagent and equipment costscan be high. Because the current system is labor intensive and costly,testing is generally restricted to centralized laboratories and oftenunavailable in developing countries. Therefore, there is a need for newapproaches to newborn testing.

SUMMARY OF THE INVENTION

The invention provides droplet actuator devices and assay methods formultiplexed newborn testing for metabolic disorders. The methodsinclude, among other things, droplet-based enzymatic assays andimmunoassays for testing for metabolic disorders. The invention includesmethods and devices for conducting multiple assays for differentmetabolic disorders on a single droplet actuator, as well as multipleassays for the same metabolic disorder using samples from differentsubjects and/or multiple samples from the same subject on a singledroplet actuator. In various embodiments, the invention includes methodsfor conducting enzymatic activity assays and/or immunoassays in a singlefresh blood and/or plasma samples and dried blood and/or plasma samples.

The invention provides assay methods for detection of one or more (i.e.,multiplex detection) lysosomal storage diseases (LSDs) on a dropletactuator. In one embodiment, the invention provides assay methods fordetection of MSP II (Hunter's syndrome) on a droplet actuator. Themethods include, among other things, droplet-based enzymatic assays foriduronate-2-sulfate sulphatase (IDS) enzyme activity. In certainembodiments, the Hunter's assay may be performed at room temperature orat an alternate temperature, such as 37° C. In other embodiments theHunter's assay may be performed for 8 hours or less. The Hunter's assayis a single-step homogenous assay that is performed at a single pH(i.e., pH 5.0) with a time to result of 8 hours or less.

In yet another embodiment, the invention provides an integrated dropletactuator device and methods for performing multiplexed enzymatic assaysand immunoassays on a single droplet actuator using a single dried bloodspot (DBS) sample. In one example, the integrated droplet actuatordevice and methods of the invention may be used for multiplexeddetection of congenital adrenal hyperplasia (CAH), congenitalhypothyroidism (CH), cystic fibrosis (CF), galactosemia and biotimidasedeficiency (BIOT).

Using digital microfluidics technology, sub-microliter-sized dropletsmay be manipulated using high-speed transport of droplets, reliabledispensing, rapid mixing, dilution, and disposal to provide rapidsample-to-result testing. Because substantially all of the steps in asample testing protocol are performed on-chip (automated), the risk ofoperator error is substantially reduced. The flexibility,programmability and modular format of the microfluidic platform,additional assay protocols (i.e., for other disorders) may be readilyadded to an on-chip testing panel.

The droplet actuator devices and methods of the invention complementtandem mass spectrometry (MS/MS) testing by multiplexing testing ofmetabolic disorders that are not suited for MS/MS.

In yet another embodiment, the invention provides bench-based methodsfor enzymatic detection of Hunter's syndrome and Fabry disease.

In yet another embodiment, the invention provides a digital microfluidicplatform and methods for multiplexed testing for hyperbilirubinemia,glucose-6-phosphate dehydrogenase (G6PD) deficiency, and congenitalhypothyroidism (CH).

DEFINITIONS

As used herein, the following terms have the meanings indicated.

“Activate,” with reference to one or more electrodes, means affecting achange in the electrical state of the one or more electrodes which, inthe presence of a droplet, results in a droplet operation. Activation ofan electrode can be accomplished using alternating or direct current.Any suitable voltage may be used. For example, an electrode may beactivated using a voltage which is greater than about 150 V, or greaterthan about 200 V, or greater than about 250 V, or from about 275 V toabout 375 V, or about 300 V. Where alternating current is used, anysuitable frequency may be employed. For example, an electrode may beactivated using alternating current having a frequency from about 1 Hzto about 100 Hz, or from about 10 Hz to about 60 Hz, or from about 20 Hzto about 40 Hz, or about 30 Hz.

“Bead,” with respect to beads on a droplet actuator, means any bead orparticle that is capable of interacting with a droplet on or inproximity with a droplet actuator. Beads may be any of a wide variety ofshapes, such as spherical, generally spherical, egg shaped, disc shaped,cubical, amorphous and other three dimensional shapes. The bead may, forexample, be capable of being subjected to a droplet operation in adroplet on a droplet actuator or otherwise configured with respect to adroplet actuator in a manner which permits a droplet on the dropletactuator to be brought into contact with the bead on the dropletactuator and/or off the droplet actuator. Beads may be provided in adroplet, in a droplet operations gap, or on a droplet operationssurface. Beads may be provided in a reservoir that is external to adroplet operations gap or situated apart from a droplet operationssurface, and the reservoir may be associated with a fluid path thatpermits a droplet including the beads to be brought into a dropletoperations gap or into contact with a droplet operations surface. Beadsmay be manufactured using a wide variety of materials, including forexample, resins, and polymers. The beads may be any suitable size,including for example, microbeads, microparticles, nanobeads andnanoparticles. In some cases, beads are magnetically responsive; inother cases beads are not significantly magnetically responsive. Formagnetically responsive beads, the magnetically responsive material mayconstitute substantially all of a bead, a portion of a bead, or only onecomponent of a bead. The remainder of the bead may include, among otherthings, polymeric material, coatings, and moieties which permitattachment of an assay reagent. Examples of suitable beads include flowcytometry microbeads, polystyrene microparticles and nanoparticles,functionalized polystyrene microparticles and nanoparticles, coatedpolystyrene microparticles and nanoparticles, silica microbeads,fluorescent microspheres and nanospheres, functionalized fluorescentmicrospheres and nanospheres, coated fluorescent microspheres andnanospheres, color dyed microparticles and nanoparticles, magneticmicroparticles and nanoparticles, superparamagnetic microparticles andnanoparticles (e.g., DYNABEADS® particles, available from InvitrogenGroup, Carlsbad, Calif.), fluorescent microparticles and nanoparticles,coated magnetic microparticles and nanoparticles, ferromagneticmicroparticles and nanoparticles, coated ferromagnetic microparticlesand nanoparticles, and those described in U.S. Patent Publication Nos.20050260686, entitled “Multiplex flow assays preferably with magneticparticles as solid phase,” published on Nov. 24, 2005; 20030132538,entitled “Encapsulation of discrete quanta of fluorescent particles,”published on Jul. 17, 2003; 20050118574, entitled “Multiplexed Analysisof Clinical Specimens Apparatus and Method,” published on Jun. 2, 2005;20050277197. Entitled “Microparticles with Multiple Fluorescent Signalsand Methods of Using Same,” published on Dec. 15, 2005; 20060159962,entitled “Magnetic Microspheres for use in Fluorescence-basedApplications,” published on Jul. 20, 2006; the entire disclosures ofwhich are incorporated herein by reference for their teaching concerningbeads and magnetically responsive materials and beads. Beads may bepre-coupled with a biomolecule or other substance that is able to bindto and form a complex with a biomolecule. Beads may be pre-coupled withan antibody, protein or antigen, DNA/RNA probe or any other moleculewith an affinity for a desired target. Examples of droplet actuatortechniques for immobilizing magnetically responsive beads and/ornon-magnetically responsive beads and/or conducting droplet operationsprotocols using beads are described in U.S. patent application Ser. No.11/639,566, entitled “Droplet-Based Particle Sorting,” filed on Dec. 15,2006; U.S. Patent Application No. 61/039,183, entitled “MultiplexingBead Detection in a Single Droplet,” filed on Mar. 25, 2008; U.S. PatentApplication No. 61/047,789, entitled “Droplet Actuator Devices andDroplet Operations Using Beads,” filed on Apr. 25, 2008; U.S. PatentApplication No. 61/086,183, entitled “Droplet Actuator Devices andMethods for Manipulating Beads,” filed on Aug. 5, 2008; InternationalPatent Application No. PCT/US2008/053545, entitled “Droplet ActuatorDevices and Methods Employing Magnetic Beads,” filed on Feb. 11, 2008;International Patent Application No. PCT/US2008/058018, entitled“Bead-based Multiplexed Analytical Methods and Instrumentation,” filedon Mar. 24, 2008; International Patent Application No.PCT/US2008/058047, “Bead Sorting on a Droplet Actuator,” filed on Mar.23, 2008; and International Patent Application No. PCT/US2006/047486,entitled “Droplet-based Biochemistry,” filed on Dec. 11, 2006; theentire disclosures of which are incorporated herein by reference. Beadcharacteristics may be employed in the multiplexing aspects of theinvention. Examples of beads having characteristics suitable formultiplexing, as well as methods of detecting and analyzing signalsemitted from such beads, may be found in U.S. Patent Publication No.20080305481, entitled “Systems and Methods for Multiplex Analysis of PCRin Real Time,” published on Dec. 11, 2008; U.S. Patent Publication No.20080151240, “Methods and Systems for Dynamic Range Expansion,”published on Jun. 26, 2008; U.S. Patent Publication No. 20070207513,entitled “Methods, Products, and Kits for Identifying an Analyte in aSample,” published on Sep. 6, 2007; U.S. Patent Publication No.20070064990, entitled “Methods and Systems for Image Data Processing,”published on Mar. 22, 2007; U.S. Patent Publication No. 20060159962,entitled “Magnetic Microspheres for use in Fluorescence-basedApplications,” published on Jul. 20, 2006; U.S. Patent Publication No.20050277197, entitled “Microparticles with Multiple Fluorescent Signalsand Methods of Using Same,” published on Dec. 15, 2005; and U.S. PatentPublication No. 20050118574, entitled “Multiplexed Analysis of ClinicalSpecimens Apparatus and Method,” published on Jun. 2, 2005.

“Blood Sample” includes whole blood, whole blood constituents, such asserum or plasma, and dried blood spot extracts. The dried blood can beon tissue paper or standard blood collection card or any other suitablesubstrate that does not eliminate the usefulness of the blood as asample for the target of interest. The blood may be from the subject,and the subject may be a human subject of any age, such as an adult,infant or a fetus. In the case of a fetus, the blood may be from themother.

“Droplet” means a volume of liquid on a droplet actuator. A droplet maybe at least partially bounded by a filler fluid. For example, a dropletmay be completely surrounded by a filler fluid or may be bounded byfiller fluid and one or more surfaces of the droplet actuator. Asanother example, a droplet may be bounded by filler fluid, one or moresurfaces of the droplet actuator, and/or the atmosphere. As yet anotherexample, a droplet may be bounded by filler fluid and the atmosphere.Droplets may, for example, be aqueous or non-aqueous or may be mixturesor emulsions including aqueous and non-aqueous components. A 1× dropletmay be about 300 nl. Droplets may take a wide variety of shapes;non-limiting examples include generally disc shaped, slug shaped,truncated sphere, ellipsoid, spherical, partially compressed sphere,hemispherical, ovoid, cylindrical, combinations of such shapes, andvarious shapes formed during droplet operations, such as merging orsplitting or formed as a result of contact of such shapes with one ormore surfaces of a droplet actuator. For examples of droplet fluids thatmay be subjected to droplet operations using the approach of theinvention, see International Patent Application No. PCT/US 06/47486,entitled, “Droplet-Based Biochemistry,” filed on Dec. 11, 2006. Invarious embodiments, a droplet may include a biological sample, such aswhole blood, lymphatic fluid, serum, plasma, sweat, tear, saliva,sputum, cerebrospinal fluid, amniotic fluid, seminal fluid, vaginalexcretion, serous fluid, synovial fluid, pericardial fluid, peritonealfluid, pleural fluid, transudates, exudates, cystic fluid, bile, urine,gastric fluid, intestinal fluid, fecal samples, liquids containingsingle or multiple cells, liquids containing organelles, fluidizedtissues, fluidized organisms, liquids containing multi-celled organisms,biological swabs and biological washes. Moreover, a droplet may includea reagent, such as water, deionized water, saline solutions, acidicsolutions, basic solutions, detergent solutions and/or buffers. Otherexamples of droplet contents include reagents, such as a reagent for abiochemical protocol, such as a nucleic acid amplification protocol, anaffinity-based assay protocol, an enzymatic assay protocol, a sequencingprotocol, and/or a protocol for analyses of biological fluids. Invarious embodiments the droplets may include surfactants to improvedroplet operations. It will be appreciated that where specificsurfactants are mentioned, these may readily be supplemented or replacedwith other similar surfactants, such as surfactants having similar HLBprofile.

“Droplet Actuator” means a device for manipulating droplets. Forexamples of droplet actuators, see Pamula et al., U.S. Pat. No.6,911,132, entitled “Apparatus for Manipulating Droplets byElectrowetting-Based Techniques,” issued on Jun. 28, 2005; Pamula etal., U.S. patent application Ser. No. 11/343,284, entitled “Apparatusesand Methods for Manipulating Droplets on a Printed Circuit Board,” filedon filed on Jan. 30, 2006; Pollack et al., International PatentApplication No. PCT/US2006/047486, entitled “Droplet-BasedBiochemistry,” filed on Dec. 11, 2006; Shenderov, U.S. Pat. No.6,773,566, entitled “Electrostatic Actuators for Microfluidics andMethods for Using Same,” issued on Aug. 10, 2004 and U.S. Pat. No.6,565,727, entitled “Actuators for Microfluidics Without Moving Parts,”issued on Jan. 24, 2000; Kim and/or Shah et al., U.S. patent applicationSer. No. 10/343,261, entitled “Electrowetting-driven Micropumping,”filed on Jan. 27, 2003, Ser. No. 11/275,668, entitled “Method andApparatus for Promoting the Complete Transfer of Liquid Drops from aNozzle,” filed on Jan. 23, 2006, Ser. No. 11/460,188, entitled “SmallObject Moving on Printed Circuit Board,” filed on Jan. 23, 2006, Ser.No. 12/465,935, entitled “Method for Using Magnetic Particles in DropletMicrofluidics,” filed on May 14, 2009, and Ser. No. 12/513,157, entitled“Method and Apparatus for Real-time Feedback Control of ElectricalManipulation of Droplets on Chip,” filed on Apr. 30, 2009; Velev, U.S.Pat. No. 7,547,380, entitled “Droplet Transportation Devices and MethodsHaving a Fluid Surface,” issued on Jun. 16, 2009; Sterling et al., U.S.Pat. No. 7,163,612, entitled “Method, Apparatus and Article forMicrofluidic Control via Electrowetting, for Chemical, Biochemical andBiological Assays and the Like,” issued on Jan. 16, 2007; Becker andGascoyne et al., U.S. Pat. No. 7,641,779, entitled “Method and Apparatusfor Programmable fluidic Processing,” issued on Jan. 5, 2010, and U.S.Pat. No. 6,977,033, entitled “Method and Apparatus for Programmablefluidic Processing,” issued on Dec. 20, 2005; Decre et al., U.S. Pat.No. 7,328,979, entitled “System for Manipulation of a Body of Fluid,”issued on Feb. 12, 2008; Yamakawa et al., U.S. Patent Pub. No.20060039823, entitled “Chemical Analysis Apparatus,” published on Feb.23, 2006; Wu, International Patent Pub. No. WO/2009/003184, entitled“Digital Microfluidics Based Apparatus for Heat-exchanging ChemicalProcesses,” published on Dec. 31, 2008; Fouillet et al., U.S. PatentPub. No. 20090192044, entitled “Electrode Addressing Method,” publishedon Jul. 30, 2009; Fouillet et al., U.S. Pat. No. 7,052,244, entitled“Device for Displacement of Small Liquid Volumes Along a Micro-catenaryLine by Electrostatic Forces,” issued on May 30, 2006; Marchand et al.,U.S. Patent Pub. No. 20080124252, entitled “Droplet Microreactor,”published on May 29, 2008; Adachi et al., U.S. Patent Pub. No.20090321262, entitled “Liquid Transfer Device,” published on Dec. 31,2009; Roux et al., U.S. Patent Pub. No. 20050179746, entitled “Devicefor Controlling the Displacement of a Drop Between two or Several SolidSubstrates,” published on Aug. 18, 2005; Dhindsa et al., “VirtualElectrowetting Channels: Electronic Liquid Transport with ContinuousChannel Functionality,” Lab Chip, 10:832-836 (2010); the entiredisclosures of which are incorporated herein by reference, along withtheir priority documents. Certain droplet actuators will include one ormore substrates arranged with a gap therebetween and electrodesassociated with (e.g., layered on, attached to, and/or embedded in) theone or more substrates and arranged to conduct one or more dropletoperations. For example, certain droplet actuators will include a base(or bottom) substrate, droplet operations electrodes associated with thesubstrate, one or more dielectric layers atop the substrate and/orelectrodes, and optionally one or more hydrophobic layers atop thesubstrate, dielectric layers and/or the electrodes forming a dropletoperations surface. A top substrate may also be provided, which isseparated from the droplet operations surface by a gap, commonlyreferred to as a droplet operations gap. Various electrode arrangementson the top and/or bottom substrates are discussed in theabove-referenced patents and applications and certain novel electrodearrangements are discussed in the description of the invention. Duringdroplet operations it is preferred that droplets remain in continuouscontact or frequent contact with a ground or reference electrode. Aground or reference electrode may be associated with the top substratefacing the gap, the bottom substrate facing the gap, in the gap. Whereelectrodes are provided on both substrates, electrical contacts forcoupling the electrodes to a droplet actuator instrument for controllingor monitoring the electrodes may be associated with one or both plates.In some cases, electrodes on one substrate are electrically coupled tothe other substrate so that only one substrate is in contact with thedroplet actuator. In one embodiment, a conductive material (e.g., anepoxy, such as MASTER BOND™ Polymer System EP79, available from MasterBond, Inc., Hackensack, N.J.) provides the electrical connection betweenelectrodes on one substrate and electrical paths on the othersubstrates, e.g., a ground electrode on a top substrate may be coupledto an electrical path on a bottom substrate by such a conductivematerial. Where multiple substrates are used, a spacer may be providedbetween the substrates to determine the height of the gap therebetweenand define dispensing reservoirs. The spacer height may, for example, befrom about 5 μm to about 600 μm, or about 100 μm to about 400 μm, orabout 200 μm to about 350 μm, or about 250 μm to about 300 μm, or about275 μm. The spacer may, for example, be formed of a layer of projectionsform the top or bottom substrates, and/or a material inserted betweenthe top and bottom substrates. One or more openings may be provided inthe one or more substrates for forming a fluid path through which liquidmay be delivered into the droplet operations gap. The one or moreopenings may in some cases be aligned for interaction with one or moreelectrodes, e.g., aligned such that liquid flowed through the openingwill come into sufficient proximity with one or more droplet operationselectrodes to permit a droplet operation to be effected by the dropletoperations electrodes using the liquid. The base (or bottom) and topsubstrates may in some cases be formed as one integral component. One ormore reference electrodes may be provided on the base (or bottom) and/ortop substrates and/or in the gap. Examples of reference electrodearrangements are provided in the above referenced patents and patentapplications. In various embodiments, the manipulation of droplets by adroplet actuator may be electrode mediated, e.g., electrowettingmediated or dielectrophoresis mediated or Coulombic force mediated.Examples of other techniques for controlling droplet operations that maybe used in the droplet actuators of the invention include using devicesthat induce hydrodynamic fluidic pressure, such as those that operate onthe basis of mechanical principles (e.g. external syringe pumps,pneumatic membrane pumps, vibrating membrane pumps, vacuum devices,centrifugal forces, piezoelectric/ultrasonic pumps and acoustic forces);electrical or magnetic principles (e.g. electroosmotic flow,electrokinetic pumps, ferrofluidic plugs, electrohydrodynamic pumps,attraction or repulsion using magnetic forces and magnetohydrodynamicpumps); thermodynamic principles (e.g. gas bubblegeneration/phase-change-induced volume expansion); other kinds ofsurface-wetting principles (e.g. electrowetting, and optoelectrowetting,as well as chemically, thermally, structurally and radioactively inducedsurface-tension gradients); gravity; surface tension (e.g., capillaryaction); electrostatic forces (e.g., electroosmotic flow); centrifugalflow (substrate disposed on a compact disc and rotated); magnetic forces(e.g., oscillating ions causes flow); magnetohydrodynamic forces; andvacuum or pressure differential. In certain embodiments, combinations oftwo or more of the foregoing techniques may be employed to conduct adroplet operation in a droplet actuator of the invention. Similarly, oneor more of the foregoing may be used to deliver liquid into a dropletoperations gap, e.g., from a reservoir in another device or from anexternal reservoir of the droplet actuator (e.g., a reservoir associatedwith a droplet actuator substrate and a fluid path from the reservoirinto the droplet operations gap). Droplet operations surfaces of certaindroplet actuators of the invention may be made from hydrophobicmaterials or may be coated or treated to make them hydrophobic. Forexample, in some cases some portion or all of the droplet operationssurfaces may be derivatized with low surface-energy materials orchemistries, e.g., by deposition or using in situ synthesis usingcompounds such as poly- or per-fluorinated compounds in solution orpolymerizable monomers. Examples include TEFLON® AF (available fromDuPont, Wilmington, Del.), members of the cytop family of materials,coatings in the FLUOROPEL® family of hydrophobic and superhydrophobiccoatings (available from Cytonix Corporation, Beltsville, Md.), silanecoatings, fluorosilane coatings, hydrophobic phosphonate derivatives(e.g., those sold by Aculon, Inc), and NOVEC™ electronic coatings(available from 3M Company, St. Paul, Minn.), and other fluorinatedmonomers for plasma-enhanced chemical vapor deposition (PECVD). In somecases, the droplet operations surface may include a hydrophobic coatinghaving a thickness ranging from about 10 nm to about 1,000 nm. Moreover,in some embodiments, the top substrate of the droplet actuator includesan electrically conducting organic polymer, which is then coated with ahydrophobic coating or otherwise treated to make the droplet operationssurface hydrophobic. For example, the electrically conducting organicpolymer that is deposited onto a plastic substrate may bepoly(3,4-ethylenedioxythiophene)poly(styrenesulfonate) (PEDOT:PSS).Other examples of electrically conducting organic polymers andalternative conductive layers are described in Pollack et al.,International Patent Application No. PCT/US2010/040705, entitled“Droplet Actuator Devices and Methods,” the entire disclosure of whichis incorporated herein by reference. One or both substrates may befabricated using a printed circuit board (PCB), glass, indium tin oxide(ITO)-coated glass or polymer, and/or semiconductor materials as thesubstrate. When the substrate is ITO-coated glass, the ITO coating ispreferably a thickness in the range of about 20 to about 200 nm,preferably about 50 to about 150 nm, or about 75 to about 125 nm, orabout 100 nm. In some cases, the top and/or bottom substrate includes aPCB substrate that is coated with a dielectric, such as a polyimidedielectric, which may in some cases also be coated or otherwise treatedto make the droplet operations surface hydrophobic. When the substrateincludes a PCB, the following materials are examples of suitablematerials: MITSUI™ BN-300 (available from MITSUI Chemicals America,Inc., San Jose Calif.); ARLON™ 11N (available from Arlon, Inc, SantaAna, Calif.).; NELCO® N4000-6 and N5000-30/32 (available from ParkElectrochemical Corp., Melville, N.Y.); ISOLA™ FR406 (available fromIsola Group, Chandler, Ariz.), especially IS620; fluoropolymer family(suitable for fluorescence detection since it has low backgroundfluorescence); polyimide family; polyester; polyethylene naphthalate;polycarbonate; polyetheretherketone; liquid crystal polymer;cyclo-olefin copolymer (COC); cyclo-olefin polymer (COP); aramid;THERMOUNT® nonwoven aramid reinforcement (available from DuPont,Wilmington, Del.); NOMEX® brand fiber (available from DuPont,Wilmington, Del.); and paper. Various materials are also suitable foruse as the dielectric component of the substrate. Examples include:vapor deposited dielectric, such as PARYLENE™ C (especially on glass)and PARYLENE™ N (available from Parylene Coating Services, Inc., Katy,Tex.); TEFLON® AF coatings; cytop; soldermasks, such as liquidphotoimageable soldermasks (e.g., on PCB) like TAIYO™ PSR4000 series,TAIYO™ PSR and AUS series (available from Taiyo America, Inc. CarsonCity, Nev.) (good thermal characteristics for applications involvingthermal control), and PROBIMER™ 8165 (good thermal characteristics forapplications involving thermal control (available from Huntsman AdvancedMaterials Americas Inc., Los Angeles, Calif.); dry film soldermask, suchas those in the VACREL® dry film soldermask line (available from DuPont,Wilmington, Del.); film dielectrics, such as polyimide film (e.g.,KAPTON® polyimide film, available from DuPont, Wilmington, Del.),polyethylene, and fluoropolymers (e.g., FEP), polytetrafluoroethylene;polyester; polyethylene naphthalate; cyclo-olefin copolymer (COC);cyclo-olefin polymer (COP); any other PCB substrate material listedabove; black matrix resin; and polypropylene. Droplet transport voltageand frequency may be selected for performance with reagents used inspecific assay protocols. Design parameters may be varied, e.g., numberand placement of on-chip reservoirs, number of independent electrodeconnections, size (volume) of different reservoirs, placement ofmagnets/bead washing zones, electrode size, inter-electrode pitch, andgap height (between top and bottom substrates) may be varied for usewith specific reagents, protocols, droplet volumes, etc. In some cases,a substrate of the invention may derivatized with low surface-energymaterials or chemistries, e.g., using deposition or in situ synthesisusing poly- or per-fluorinated compounds in solution or polymerizablemonomers. Examples include TEFLON® AF coatings and FLUOROPEL® coatingsfor dip or spray coating, and other fluorinated monomers forplasma-enhanced chemical vapor deposition (PECVD). Additionally, in somecases, some portion or all of the droplet operations surface may becoated with a substance for reducing background noise, such asbackground fluorescence from a PCB substrate. For example, thenoise-reducing coating may include a black matrix resin, such as theblack matrix resins available from Toray industries, Inc., Japan.Electrodes of a droplet actuator may be controlled by a controller or aprocessor, which is itself provided as part of a system, which mayinclude processing functions as well as data and software storage andinput and output capabilities.

“Droplet operation” means any manipulation of a droplet on a dropletactuator. A droplet operation may, for example, include: loading adroplet into the droplet actuator; dispensing one or more droplets froma source droplet; splitting, separating or dividing a droplet into twoor more droplets; transporting a droplet from one location to another inany direction; merging or combining two or more droplets into a singledroplet; diluting a droplet; mixing a droplet; agitating a droplet;deforming a droplet; retaining a droplet in position; incubating adroplet; heating a droplet; vaporizing a droplet; cooling a droplet;disposing of a droplet; transporting a droplet out of a dropletactuator; other droplet operations described herein; and/or anycombination of the foregoing. The terms “merge,” “merging,” “combine,”“combining” and the like are used to describe the creation of onedroplet from two or more droplets. It should be understood that whensuch a term is used in reference to two or more droplets, anycombination of droplet operations that are sufficient to result in thecombination of the two or more droplets into one droplet may be used.For example, “merging droplet A with droplet B,” can be achieved bytransporting droplet A into contact with a stationary droplet B,transporting droplet B into contact with a stationary droplet A, ortransporting droplets A and B into contact with each other. The terms“splitting,” “separating” and “dividing” are not intended to imply anyparticular outcome with respect to volume of the resulting droplets(i.e., the volume of the resulting droplets can be the same ordifferent) or number of resulting droplets (the number of resultingdroplets may be 2, 3, 4, 5 or more). The term “mixing” refers to dropletoperations which result in more homogenous distribution of one or morecomponents within a droplet. Examples of “loading” droplet operationsinclude microdialysis loading, pressure assisted loading, roboticloading, passive loading, and pipette loading. Droplet operations may beelectrode-mediated. In some cases, droplet operations are furtherfacilitated by the use of hydrophilic and/or hydrophobic regions onsurfaces and/or by physical obstacles. For examples of dropletoperations, see the patents and patent applications cited above underthe definition of “droplet actuator.” Impedance or capacitance sensingor imaging techniques may sometimes be used to determine or confirm theoutcome of a droplet operation. Examples of such techniques aredescribed in Sturmer et al., International Patent Pub. No.WO/2008/101194, entitled “Capacitance Detection in a Droplet Actuator,”published on Aug. 21, 2008, the entire disclosure of which isincorporated herein by reference. Generally speaking, the sensing orimaging techniques may be used to confirm the presence or absence of adroplet at a specific electrode. For example, the presence of adispensed droplet at the destination electrode following a dropletdispensing operation confirms that the droplet dispensing operation waseffective. Similarly, the presence of a droplet at a detection spot atan appropriate step in an assay protocol may confirm that a previous setof droplet operations has successfully produced a droplet for detection.Droplet transport time can be quite fast. For example, in variousembodiments, transport of a droplet from one electrode to the next mayexceed about 1 sec, or about 0.1 sec, or about 0.01 sec, or about 0.001sec. In one embodiment, the electrode is operated in AC mode but isswitched to DC mode for imaging. It is helpful for conducting dropletoperations for the footprint area of droplet to be similar toelectrowetting area; in other words, 1×-, 2×- 3×-droplets are usefullycontrolled operated using 1, 2, and 3 electrodes, respectively. If thedroplet footprint is greater than the number of electrodes available forconducting a droplet operation at a given time, the difference betweenthe droplet size and the number of electrodes should typically not begreater than 1; in other words, a 2× droplet is usefully controlledusing 1 electrode and a 3× droplet is usefully controlled using 2electrodes. When droplets include beads, it is useful for droplet sizeto be equal to the number of electrodes controlling the droplet, e.g.,transporting the droplet.

“Filler fluid” means a fluid associated with a droplet operationssubstrate of a droplet actuator, which fluid is sufficiently immisciblewith a droplet phase to render the droplet phase subject toelectrode-mediated droplet operations. For example, the gap of a dropletactuator may be filled with a filler fluid. The filler fluid may, forexample, be a low-viscosity oil, such as silicone oil or an alkanefiller fluid, such as hexadecane filler fluid. The filler fluid may fillthe entire gap of the droplet actuator or may coat one or more surfacesof the droplet actuator. Filler fluids may be conductive ornon-conductive. Filler fluids may, for example, be doped withsurfactants or other additives. For example, additives may be selectedto improve droplet operations and/or reduce loss of reagent or targetsubstances from droplets, formation of microdroplets, crosscontamination between droplets, contamination of droplet actuatorsurfaces, degradation of droplet actuator materials, etc. Composition ofthe filler fluid, including surfactant doping, may be selected forperformance with reagents used in the specific assay protocols andeffective interaction or non-interaction with droplet actuatormaterials. Examples of filler fluids and filler fluid formulationssuitable for use with the invention are provided in Srinivasan et al,International Patent Pub. Nos. WO/2010/027894, entitled “DropletActuators, Modified Fluids and Methods,” published on Mar. 11, 2010, andWO/2009/021173, entitled “Use of Additives for Enhancing DropletOperations,” published on Feb. 12, 2009; Sista et al., InternationalPatent Pub. No. WO/2008/098236, entitled “Droplet Actuator Devices andMethods Employing Magnetic Beads,” published on Aug. 14, 2008; andMonroe et al., U.S. Patent Publication No. 20080283414, entitled“Electrowetting Devices,” filed on May 17, 2007; the entire disclosuresof which are incorporated herein by reference, as well as the otherpatents and patent applications cited herein.

“Immobilize” with respect to magnetically responsive beads, means thatthe beads are substantially restrained in position in a droplet or infiller fluid on a droplet actuator. For example, in one embodiment,immobilized beads are sufficiently restrained in position in a dropletto permit execution of a droplet splitting operation, yielding onedroplet with substantially all of the beads and one dropletsubstantially lacking in the beads.

“Magnetically responsive” means responsive to a magnetic field.“Magnetically responsive beads” include or are composed of magneticallyresponsive materials. Examples of magnetically responsive materialsinclude paramagnetic materials, ferromagnetic materials, ferrimagneticmaterials, and metamagnetic materials. Examples of suitable paramagneticmaterials include iron, nickel, and cobalt, as well as metal oxides,such as Fe₃O₄, BaFe₁₂O₁₉, CoO, NiO, Mn₂O₃, Cr₂O₃, and CoMnP.

“Washing” with respect to washing a bead means reducing the amountand/or concentration of one or more substances in contact with the beador exposed to the bead from a droplet in contact with the bead. Thereduction in the amount and/or concentration of the substance may bepartial, substantially complete, or even complete. The substance may beany of a wide variety of substances; examples include target substancesfor further analysis, and unwanted substances, such as components of asample, contaminants, and/or excess reagent. In some embodiments, awashing operation begins with a starting droplet in contact with amagnetically responsive bead, where the droplet includes an initialamount and initial concentration of a substance. The washing operationmay proceed using a variety of droplet operations. The washing operationmay yield a droplet including the magnetically responsive bead, wherethe droplet has a total amount and/or concentration of the substancewhich is less than the initial amount and/or concentration of thesubstance. Examples of suitable washing techniques are described inPamula et al., U.S. Pat. No. 7,439,014, entitled “Droplet-Based SurfaceModification and Washing,” granted on Oct. 21, 2008, the entiredisclosure of which is incorporated herein by reference.

The terms “top,” “bottom,” “over,” “under,” and “on” are used throughoutthe description with reference to the relative positions of componentsof the droplet actuator, such as relative positions of top and bottomsubstrates of the droplet actuator. It will be appreciated that thedroplet actuator is functional regardless of its orientation in space.

When a liquid in any form (e.g., a droplet or a continuous body, whethermoving or stationary) is described as being “on”, “at”, or “over” anelectrode, array, matrix or surface, such liquid could be either indirect contact with the electrode/array/matrix/surface, or could be incontact with one or more layers or films that are interposed between theliquid and the electrode/array/matrix/surface.

When a droplet is described as being “on” or “loaded on” a dropletactuator, it should be understood that the droplet is arranged on thedroplet actuator in a manner which facilitates using the dropletactuator to conduct one or more droplet operations on the droplet, thedroplet is arranged on the droplet actuator in a manner whichfacilitates sensing of a property of or a signal from the droplet,and/or the droplet has been subjected to a droplet operation on thedroplet actuator.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows a flow diagram of an enzymatic assay protocol for Hunter'ssyndrome;

FIG. 2 shows a plot of the effect of plasma dilution on a modifiedHunter's assay;

FIG. 3 shows a plot of the concentration dependence of recombinantiduronidase on the modified Hunter's assay;

FIGS. 4A and 4B show plots of affected and normal plasma samplesscreened for MSPII using the modified Hunter's assay of FIG. 2;

FIG. 5 shows a plot of a standard curve for recombinant iduronidaseactivity in the presence of BSA;

FIGS. 6A and 6B show plots of a Hunter's assay using recombinantiduronidase formulated with BSA;

FIG. 7 shows a plot of the effect of extraction volume on Hunter's assayusing DBS extracts;

FIG. 8 illustrates a top view of an example of a droplet actuator thatis suitable for use in conducting multiplexed enzymatic assays in anewborn testing protocol;

FIG. 9 shows an example of a plot of multiplexed testing for Pompe andFabry diseases using extracts from single DBS punch;

FIG. 10 shows an example of a plot of a standard curve for thyroidstimulating hormone (TSH);

FIG. 11 illustrates a top view of an example of a droplet actuator thatis suitable for use in conducting an integrated enzymatic assay andimmunoassay newborn testing protocol;

FIG. 12 illustrates a side view of an example of a detection system forsimultaneous fluorescence and absorbance detection of multiple dropletson a single droplet actuator;

FIG. 13 shows a diagram of an assay protocol for evaluating the effectof β-cyclodextrins on 4-MU partitioning;

FIGS. 14A and 14B show plots of the concentration free 4-MU as afunction of β-cyclodextrin:4-MU molar ratio;

FIG. 15 shows a plot of an expected BE signal (back extraction) as afunction of free 4-MU concentration at equilibrium in FE (forwardextraction);

FIGS. 16A through 16G show screenshots of an example of an experimentdesigned to evaluate the effect of cyclodextrins, pH and ionic strengthon aqueous containment of 4-MU;

FIGS. 17A and 17B show data tables of fluorescence readings for forwardtransfer and backward transfer, respectively, of the 4-MU partitioningassay of Tables 5 and 6;

FIGS. 18A and 18B show data tables of another example of a 4-MUpartitioning assay;

FIG. 19 shows a data table of relative fluorescence readings forbackward transfer partitioning (backward extraction; BE) of a 4-MUpartitioning assay used to evaluate the effect of aqueous phasesurfactants on 4-MU containment;

FIGS. 20A and 20B show bar graphs of the effect ofhydroxypropyl-β-cyclodextrin and methyl-β-cyclodextrin, respectively, onsubstrate hydrolysis in a Fabry assay;

FIGS. 21A and 21B show bar graphs of the effect ofhydroxypropyl-β-cyclodextrin and methyl-β-cyclodextrin, respectively, onsubstrate hydrolysis in a Gaucher assay;

FIGS. 22A and 22B show bar graphs of the effect of lower concentrationsof hydroxypropyl-β-cyclodextrin and methyl-β-cyclodextrin, respectively,on substrate hydrolysis in a Fabry assay;

FIGS. 23A and 23B show bar graphs of the effect of lower concentrationsof hydroxypropyl-β-cyclodextrin and methyl-β-cyclodextrin, respectively,on substrate hydrolysis in a Gaucher assay;

FIG. 24 illustrates a top view of an example of an electrode arrangementof a droplet actuator configured for performing multiplexed Pompe, Fabryand Hunter's assays;

FIG. 25 shows a plot of IDS activity in a Hunter's assay performed onthe digital microfluidic platform using extracts from DBS samples;

FIG. 26 shows a bar graph of fluorescence data of a single-step on benchassay for Hunter's syndrome;

FIG. 27 shows a bar graph of another example of fluorescence data of asingle-step assay for Hunter's syndrome;

FIGS. 28A and 28B show plots of bilirubin calibration curves obtainedon-chip and a scatter plot of values, respectively;

FIG. 29 shows a plot of the G6PD assay performed on-chip;

FIG. 30 shows a plot of a TSH calibration curve generated on-chip;

FIG. 31 illustrates a flow diagram of an example of a protocol formultiplexed newborn testing for total bilirubin, G6PD and TSH on adroplet actuator;

FIG. 32 shows a top view of an example of an electrode arrangement of adroplet actuator configured for performing multiplexed total bilirubin,G6PD and TSH assays on a droplet actuator;

FIG. 33 illustrates a top view of a portion of a droplet actuator thatincludes optically transparent detection electrodes suitable fordetection of colorimetric reaction products; and

FIG. 34 illustrates a perspective view of an example of a detectionsystem for detection of colorimetric reaction products.

FIGS. 35 A-H illustrates examples of individual 4-HMU analog structures.

FIGS. 36 A-H illustrates examples of individual 6-HMU analog structures.

DESCRIPTION

The invention provides droplet actuator devices and methods ofconducting testing. For example, the methods of testing include methodsof testing samples for activity of certain enzymes. In one embodiment,the enzymes tested are enzymes associated with metabolic disorders. Thetesting may be associated with screening programs (e.g., screeningnewborn infants for metabolic disorders), diagnostics, monitoring,screening of modified enzymes, or for any other useful purpose.

The invention includes methods and devices for conducting multipleassays for different metabolic disorders on a single droplet actuator,as well as multiple assays for the same metabolic disorder using samplesfrom different subjects and/or multiple samples from the same subject ona single droplet actuator.

The invention provides modified assays for detecting altered enzymaticactivity. Among the enzyme assays which may be conducted according tothe methods of the invention are those methods useful in the diagnosisof defects in glycosidases, such as lysosomal storage diseases.Enzymatic indicators of lysosomal storage diseases can be identifiedusing droplet based assays on a droplet actuator. Assays of theappropriate glycosidase activity can be used to detect altered activityof a particular glycosidase, which may be an indicator of a particularlysosomal storage disease. A deficiency in .alpha.-glucosidase activity,for example, is a diagnostic indicator of Pompe disease. Similarly, adeficiency in .alpha.-galactosidase activity is a diagnostic indicatorof Fabry disease. Multiple diseases and/or multiple samples can betested simultaneously on a single droplet actuator.

In some embodiments, the invention provides diagnostic techniques formetabolic disorders that result from defects in lysosomal function.Examples include, without limitation: activator deficiency/GM2gangliosidosis; alpha-mannosidosis; aspartylglucosaminuria; cholesterylester storage disease; chronic hexosaminidase a deficiency; cystinosis;Danon disease; Fabry disease; Farber disease; fucosidosis;galactosialidosis; Gaucher disease (Type I, Type II, Type III); GM1gangliosidosis (infantile, late infantile/juvenile, adult/chronic);1-cell disease/mucolipidosis II; infantile free sialic acid storagedisease/ISSD; juvenile hexosaminidase A deficiency; Krabbe disease(infantile onset, late onset); metachromatic leukodystrophy;mucopolysaccharidoses disorders (pseudo-hurlerpolydystrophy/mucolipidosis IIIA, PSI Hurler syndrome, MPSI Scheiesyndrome, MPS I Hurler-Scheie syndrome, MPS II Hunter syndrome,Sanfilippo syndrome Type A/MPS III A, Sanfilippo syndrome Type B/MPS IIIB, Sanfilippo syndrome Type C/MPS III C, Sanfilippo syndrome Type D/MPSIII D, Morquio type A/MPS IVA, morquio Type B/MPS IVB, MPS IXhyaluronidase deficiency, MPS VI Maroteaux-Lamy, MPS VII Sly syndrome,mucolipidosis I/Sialidosis, mucolipidosis IIIC, mucolipidosis type IV);Maroteaux-Lamy; multiple sulfatase deficiency; Niemann-Pick disease(Type A, Type B, Type C); Neuronal ceroid lipofuscinoses (CLN6disease—Atypical late infantile, late onset variant, early juvenile,Batten-Spielmeyer-Vogt/juvenile NCL/CLN3 disease, Finnish variant lateinfantile CLN5, Jansky-Bielschowsky disease/late infantile CLN2/TPP1disease, Kufs/adult-onset NCL/CLN4 disease, northern epilepsy/variantlate infantile CLN8, Santavuori-Haltia/infantile CLN1/PPT disease,beta-mannosidosis); Pompe disease/glycogen storage disease type II;Pycnodysostosis; Sandhoff disease/GM2 gangliosidosis (Adult Onset,Infantile, Juvenile); Schindler disease; Salla disease/sialic acidstorage disease; Tay-Sachs/GM2 gangliosidosis; and Wolman disease.Various enzyme-related conditions, including without limitationlysosomal storage diseases, are described in the Merck Manual, 18 ed.,Apr. 7, 2006, the entire disclosure of which is incorporated herein byreference.

In one embodiment, the invention provides assay methods for detection ofMSP II (Hunter's syndrome) on a droplet actuator. The methods include,among other things, droplet-based enzymatic assays foriduronate-2-sulfate sulphatase (IDS) enzyme activity. In certainembodiments, the Hunter's assay may be performed at room temperature orat an alternate temperature, such as 37° C. In other embodiments theHunter's assay may be performed for 8 hours or less. The Hunter's assayis a single-step homogenous assay that is performed at a single pH(i.e., pH 5.0) with a time to result of 8 hours or less.

In an embodiment the invention provides assay methods for detection ofone or more diseases related to insufficient quantity or activity of aspecific enzyme or enzymes, such as Hunter's, Gaucher and Niemann-Pickdiseases, Pompe and Fabry diseases, and Morquio B syndrome on a dropletactuator.

In yet another embodiment, the invention provides an integrated dropletactuator device and methods for performing multiplexed enzymatic assaysand immunoassays on a single droplet actuator using a single dried bloodspot (DBS) sample. In one example, the integrated droplet actuatordevice and methods of the invention may be used for one or more ofcongenital adrenal hyperplasia (CAH), congenital hypothyroidism (CH),cystic fibrosis (CF), galactosemia and biotinidase deficiency (BIOT).

It will be appreciated that while the methods of the invention areprimarily directed at droplet-based testing using microfluidic devicesor droplet actuators, the invention also provides novel chemistries thatmay be conducted using manual techniques, pipetting, robotics, or otherdevices or techniques.

The invention also provides techniques for conducting enzymaticscreening in droplets associated with, surrounded by, or otherwise incontact with, an immiscible phase, such as an oil phase, such as asilicone oil phase. For example, the invention provides for the use ofrelatively lipophilic signal molecules, such as 4-MU and its analogs, insolution with molecules that associate with and increase retention ofthe signal molecules in the aqueous phase. Examples includecyclodextrins, cyclic peptides, cyclic oligonucleotides, crown ethers,cyclic polymers, and various conjugates and combinations of theforegoing. Suitable signal retaining molecules can be selected byscreening for molecules that result in greater retention of signal intheir presence than in their absence.

The invention also provides novel substrates for conducting enzymaticassays that exhibit improved aqueous solubility. Such molecules areparticularly useful in conducting enzymatic screening in dropletssurrounded by or in contact with an immiscible phase, such as an oilphase, such as a silicone oil phase, because less signal is lost to theoil phase. Examples of modified substrates described herein are 4-MU andHMU molecules modified to add moieties that improve their aqueoussolubility without significantly diminishing their fluorescence oreliminating their suitability as an enzyme substrate. Preferred modifiedsubstrates are those which retain sufficient fluorescence and exhibitsufficient water solubility to provide greater signal under the sameassay conditions relative to the corresponding 4-MU or HMU substrates,in particular where the assay is conducted in a droplet surrounded by orin contact with, an immiscible phase, such as an oil phase, such as asilicone oil phase.

Enzymatic Assay for Hunter's Syndrome

The invention provides a two-step enzymatic assay. The assay may beperformed in a standard laboratory setting. In one embodiment it mayhave about a 24 hour turn-around time. In another embodiment it may havea turn-around time of less than or about 12 hours. In yet anotherembodiment it may have a turn-around time of less than or about 6 hours.Blood samples are obtained from a subject and spotted onto a solidmedium such as filter paper, dried and sent to a central laboratory.Because the blood samples are spotted onto a solid medium and dried,they must be reconstituted before analysis, a step that requiresdilution of the sample into a suitable liquid medium. There is a needfor an improved Hunter's assay that provides for a rapid, single-stepprotocol that may be used on fresh and/or dried blood samples (i.e.,whole blood samples, plasma samples). Hunter's syndrome is caused by areduction (or absence) of the enzyme iduronate-2-sulfate sulphatase(IDS). FIG. 1 shows a flow diagram of an enzymatic assay protocol 100for Hunter's syndrome. The assay may be performed using amicrotiter-plate based assay and microtiter plate reader (e.g., BiotekKC4 plate reader). The assay for Hunter's syndrome uses4-methylumbelliferyl-α-L-iduronide-2-sulfate (MU-αIdoA-2S) as asubstrate. The assay is a two enzyme, two step assay where IDS firstacts on the MU-αIdoA-2S substrate fluid to hydrolyze the sulfatesyielding a 4-MU-IdoA intermediate (Reaction 1). A secondary enzymeα-L-iduronidase acts on the sulfate free intermediate (4-MU-IdoA) torelease the 4-methylumbelliferone (4-MU), generating a fluorescentsignal (Reaction 2). In the absence of active IDS, the 4-MU-IdoAintermediate is not formed and no fluorescent signal is produced.Reactions 1 and 2 are performed at different pHs, pH 5.0 and pH 3.5,respectively.

The α-L-iduronidase (or any active iduronidase) may, for example, bepartially purified from bovine testis or rabbit liver and may introducesignificant concentrations of contaminating sulphatases into thereaction. To inactivate contaminating sulphatases in the L-iduronidaseextracts, a bolus of phosphate/citric acid buffer (McIlvain's buffer) isadded to the reaction prior to the second enzymatic reaction. Purifiedor synthetically produced α-L-iduronidase or analogues or derivativeswith similar activity may be used as alternatives to purifiedα-L-iduronidase.

In one example, the assay protocol includes the following steps:

-   -   1. A 5× diluted plasma sample (10 μL) is incubated with 20 μL of        1.25 mM MU-αIdoA-2S (0.1M Na acetate, 0.1M acetic acid buffer,        pH 5.0 containing 10 mM Pb-Acetate) at 37° C. for 4 h (Reaction        1);    -   2. Add 20 μL McIlvains' phosphate/citric acid buffer (Pi/Ci        buffer) to all samples (including substrate blank) and mix        (Pi/Ci buffer is added to all samples to quench the activity of        all sulphatases in the sample and in the added LEBT solution        (step 3));    -   3. Add 10 μL LEBT solution, pH 3.5 (partially purified lysosomal        extract bovine testis) to plasma samples and mix;    -   4. Incubate 24 h at 37° C. (Reaction 2); and

Add 200 μL stop buffer (sodium carbonate pH 10.1, 0.01% Tween® 20solution available from Promega Corporation, Madison, Wis.) to allsamples and read fluorescence of 4-MU.

4MU fluid substrates may be replaced or supplemented with4-trifluoromethylumbelliferyl substrates. For example,4-trifluoromethylumbelliferyl glycosides may be used as substrates forthe assay of LSD hydrolyases (sulfatases, etc.). The4-trifluoromethylumbelliferone leaving group exhibits a greater signaland the signal is shifted more to the red when compared to4-methylumbelliferone.

Enzyme Assay for Hunter's Syndrome on a Droplet Actuator

In another embodiment, the invention provides a droplet actuator-basedassay for Hunter's syndrome. The assay may be a homogeneous assay thatuses purified recombinant iduronidase. Because purified recombinantiduronidase is used, contaminating sulphatases from partially purifiedlysosmal iduronidase from bovine testis (i.e., LEBT solution) are notpresent and the addition of McIlvains' phosphate/citric acid buffer(Pi/Ci buffer) is not required. The Hunter's assay is adapted for pH,sample concentration and iduronidase enzyme activity. The substrateMU-αIdoA-2S and the recombinant iduronidase are added to the dilutedplasma sample at the same time and incubated together for the entirereaction at, for example, 25° C. (room temperature). The dropletactuator-based Hunter's assay is a homogeneous, single step assay thatis performed without requiring a substrate change in pH.

Sample droplets and reagent droplets for use in conducting the enzymaticassays may be dispensed and/or combined according to appropriate assayprotocols using droplet operations on a droplet actuator. Incubation ofassay droplets, including temperature adjustments as needed, may also beperformed on a droplet actuator. Further, detection of signals fromassay droplets, such as detection of fluorescence may be conducted whilethe droplet is present on the droplet actuator. Further, each of theseprocesses may be conducted while the droplet is partially or completelysurrounded by a filler fluid on the droplet actuator.

In some embodiments, certain assay steps may be conducted outside of adroplet actuator and certain assay steps may be conducted on a dropletactuator. For example, in some embodiments, sample and reagents may beprepared outside the droplet actuator and combined, incubated anddetected on the droplet actuator.

Effect of Plasma Dilution

Anions, such as chloride, sulfate, and phosphate, inherently present ina plasma sample are inhibitors of sulphatase activity (e.g.,iduronate-2-sulfate sulphatase (IDS)). For example, at 30 mM chloride,IDS activity is inhibited by 50% and at 250 mM chloride IDS activity iscompletely inhibited. A plasma sample may have a chloride concentrationof 150 mM, a concentration that may reduce the signal output in aHunter's assay. The amount of chloride present in a plasma sample may,for example, be reduced by dilution of the sample with a suitableliquid, such as water. Anions (e.g., chloride, sulfate, and phosphate)present in a plasma sample may also be reduced by precipitation withlead-acetate (Pb-acetate).

FIG. 2 shows a plot 200 of the effect of plasma dilution on a modifiedHunter's assay. Reagent solutions were prepared on-bench, and theexperiment was performed on a droplet actuator using a digitalmicrofluidic protocol. Different dilutions (1/10×, 1/4×, 1/3×, 1/2 and1×) of plasma samples from normal (n=1) and affected (n=1) subjects wereprepared using molecular grade water. A blank sample was prepared using1 μg/mL of recombinant iduronidase in 0.05 M Na-Acetate/0.05 M Aceticacid buffer pH 5.0. A working stock of 10 μg/mL recombinant iduronidasein 0.05 M Na-Acetate/0.05 M Acetic acid buffer pH 5.0 was prepared froma stock of 0.5 mg/mL iduronidase (supplied in 0.05 M Na-Acetate with 150mM NaCl, 0.02% Brij-35 (w/v) pH 3.5). A working stock of 1.25 mMMU-αIdoA-S substrate fluid was prepared in 0.1 M Na-Acetate, 0.1M AceticAcid buffer pH 5.0 containing 10 mM Pb-Acetate. A substrate fluid wasprepared by mixing 1 μL of 10 μg/mL recombinant iduronidase and 9 μL of1.25 mM MU-αIdoA-S.

In one example, the digital microfluidic protocol for testing plasmasample dilutions included the following steps:

-   -   1. Dispense eleven 1× droplets of the substrate fluid from a        reagent reservoir onto 11 reaction lanes of a droplet actuator;    -   2. Dispense 1× droplets of plasma samples from the respective        sample reservoirs;    -   3. Merge the plasma sample droplets with the substrate fluid        droplets to yield 2× reaction droplets;    -   4. Split each 2× reaction droplet into two 1× reaction droplets;    -   5. Dispense 11 droplets of stop buffer (sodium carbonate pH        10.1, 0.01% Tween® 20) and merge them using droplet operations        with the first set of 1× reaction droplets;    -   6. Detect fluorescence at 364 nm (t=0 h);    -   7. Incubate the second set of 1× reaction droplets for 8 h at        room temperature;    -   8. After 8 h, dispense 11 droplets of stop buffer and combine        them with the second set of 1× reaction droplets; and    -   9. Detect fluorescence at 364 nm (t=8 h).

Referring to FIG. 2, the maximum separation of fluorescence signalbetween the normal and affected plasma samples was observed at adilution of 1:4. Because one droplet of plasma sample was mixed with onedroplet of the substrate fluid, the final effective dilution of theplasma sample is 1:8. The chloride concentration at this dilution has aminimal impact on the iduraonate-2-sulfate sulphatase activity.

In various embodiments, the plasma blood sample is diluted from about1:2 to about 1:15 plasma:buffer, or from any of about 1:2, 1:3, 1:4,1:5, 1:6 or 1:7 to any of about 1:8, 1:9, 1:10, 1:11, 1:12, 1:13, 1:14or 1:15 plasma:buffer. In other embodiments, the plasma blood sample isdiluted to at least 1:2 plasma:buffer, to at least 1:3 plasma:buffer, toat least 1:4 plasma:buffer, to at least 1:5 plasma:buffer, to at least1:6 plasma:buffer, to at least 1:7 plasma:buffer, to at least 1:8plasma:buffer.

Concentration of Recombinant Iduronidase

FIG. 3 shows a plot 300 of the concentration dependence of recombinantiduronidase on the modified Hunter's assay. Eight different normalplasma samples were analyzed using two concentrations of recombinantiduronidase (i.e., 1 μg/mL and 10 μg/mL) in the modified Hunter's assay.The activity of the Hunter's assay shows a significant concentrationdependence on the amount of recombinant iduronidase used (i.e., higheractivity at 10 μg/mL). In plot 300, the thick solid line represents themean of all the readings. In plot 300, the error bars represent thestandard deviation among the readings. Because of the concentrationdependence on the amount of recombinant iduronidase used in the modifiedHunter's assay, an even higher concentration (>10 μg/mL) of recombinantiduronidase may be used.

Effect of Carrier Protein on Recombinant Iduronidase Activity

Reagent solutions were prepared outside a droplet actuator (i.e.,on-bench) and the experiments were performed on a droplet actuator usinga digital microfluidic protocol, such as the protocol of FIG. 2.

FIGS. 4A and 4B show plots 400 and 450 of affected and normal plasmasamples screened for MSPII using the modified Hunter's assay of FIG. 2.Affected (n=10) and normal (n=10) plasma samples were diluted 1:4 andanalyzed on two separate days on the same droplet actuator. Samples 1through 5 of both affected and normal samples were analyzed on day 1.Samples 6 through 10 of both affected and normal samples were analyzedon day 2. Plot 400 of FIG. 4A shows the distribution of all 10 affectedand 10 normal samples (i.e., days 1 and 2). Plot 450 of FIG. 4B showsthe distribution of samples at day 1 (1-5 affected, 1-5 normal) and day2 (6-10 affected, 6-10 normal). Referring to plot 450 of FIG. 4B, thesignal for normal samples was decreased between days 1 and 2. Thedecrease in signal for normal plasma samples at day 2 may be due to lossof iduronidase activity with time. The thick solid line represents themean of all the readings. The error bars represent the standarddeviation among the readings.

The stability of recombinant iduronidase activity may be sufficientlyincreased by incorporation of a carrier protein, such as bovine serumalbumin (BSA), into the substrate fluid.

FIG. 5 shows a plot 500 of a standard curve for recombinant iduronidaseactivity in the presence of BSA. Serial dilutions of recombinantiduronidase were prepared in 0.05 M Na-Acetate/0.05 M Acetic acidbuffer, pH 5.0 from a stock of 0.5 mg/mL recombinant iduronidasecontaining 1 mg/mL molecular biology grade bovine serum albumin (BSA). Asubstrate fluid was prepared in 0.05 M Na Acetate, pH 5.0 containing 1mM 4-methylumbelliferyl-α-L-idopyranosiduronic acid (4-MUI) and 100 μMD-saccharic acid 1,4-lactone.

The digital microfluidic protocol for the iduronidase standard curveincluded the following steps:

-   -   1. Mix one 1× droplet of iduronidase and one 1× droplet of        substrate fluid to yield a 2× reaction droplet;    -   2. Split the 2× reaction droplet into two 1× reaction droplets;    -   3. Dispense 11 droplets of stop buffer (sodium carbonate pH        10.1, 0.01% Tween® 20) and combine them with the first set of 1×        reaction droplets;    -   4. Detect end point fluorescence at 365 nm (t=0);    -   5. Incubate the second set of 1× reaction droplets for 1 h at        room temperature;    -   6. After 1 h of incubation, dispense 11 droplets of stop buffer        and combine with the reaction droplets; and    -   7. Detect end point fluorescence at 365 nm (t=1 h).

Table 1 shows the relative fluorescence of the iduronidase standardcurve at t=1 h incubation after the addition of stop buffer.

TABLE 1 Relative fluorescence at t = 1 hrs incubation Idu (μg/mL) Rfu 017.99915 0.001 34.6948 0.01 179.1927 0.1 999.3997 1 7427.665

FIGS. 6A and 6B show plots 600 and 650, respectively, of a Hunter'sassay using recombinant iduronidase formulated with BSA. Plasma samplesfrom normal (n=9; samples 2-10) and affected (n=9; samples 2-10)subjects were diluted 1:4 using molecular grade water. A blank samplewas prepared using 1 μg/mL of recombinant iduronidase in 0.05 MNa-Acetate/0.05 M Acetic acid buffer pH 5.0. A working stock of 10 μg/mLrecombinant iduronidase in 0.05 M Na-Acetate/0.05 M Acetic acid bufferpH 5.0 containing 1 mg/mL of molecular grade BSA was prepared from astock of 0.5 mg/mL iduronidase (supplied in 0.05 M Na-Acetate with 150mM NaCl, 0.02% Brij-33 (w/v) pH 3.5). A stock of 1.25 mM MU-IdoA-Ssubstrate fluid was supplied in 0.1 M Na-Acetate, 0.1 M Acetic Acidbuffer pH 5.0 containing 10 mM Pb-Acetate. A substrate fluid wasprepared by mixing 1 μL of 10 μg/mL recombinant iduronidase and 9 μL of1.25 mM MU-αIdoA-S. Final concentrations of recombinant iduronidase andMU-αIdoA-S in the reaction mixture in the droplet are 0.5 μg/mL and0.5625 mM respectively.

Plasma samples (#2-10 normal and #2-10 Hunter) were analyzed on twodifferent days. Referring to plot 600 of FIG. 6A, on day 1 a firstaliquot of normal and Hunter patient samples were analyzed on a firstdroplet actuator and instrument. Referring to plot 650 of FIG. 6B, onday 2, a second aliquot of normal and Hunter patient samples wereanalyzed on a second droplet actuator and instrument. The assays on day1 and day 2 were performed by different operators.

The digital microfluidic protocol for testing plasma samples includedthe following steps:

-   -   1. Dispense eleven 1× droplets of the substrate fluid from a        reagent reservoir onto 11 reaction lanes of a droplet actuator;    -   2. Dispense 1× droplets of plasma samples from the respective        sample reservoirs;    -   3. Merge the plasma sample droplets with the substrate fluid        droplet to yield a 2× reaction droplet;    -   4. Split the 2× reaction droplet into two 1× reaction droplets;    -   5. Dispense 11 droplets of stop buffer (0.1 M sodium bicarbonate        pH 10.1, 0.01% Tween® 20) and merge them using droplet        operations with the first set of 1× reaction droplets;    -   6. Detect fluorescence at 365 nm (t=0 h);    -   7. Incubate the second set of 1× reaction droplets for 8 h at        room temperature;    -   8. After 8 h, dispense 11 droplets of stop buffer and combine        them with the 1× reaction droplets; and    -   9. Detect fluorescence at 365 nm (t=8 h).

Referring again to plot 600 of FIG. 6A and plot 650 of FIG. 6B, at anincubation time of t=8 h there is a significant separation in thefluorescence signal between a Hunter patient's plasma sample and anormal plasma sample. The fluorescence signals for normal samplesanalyzed on day 1 and day 2 are consistent indicating stability in theassay protocol. In plots 600 and 650 the thick solid line represents themean of all the readings. In plots 600 and 650 the error bars representthe standard deviation among the readings. All data points for theHunter affected samples overlapped one another.

Because there is about a 20-100 fold separation in the fluorescencesignal between a Hunter patient's plasma sample and a normal plasmasample, the time to result and throughput of the modified Hunter's assaymay be significantly increased further. In one embodiment, the overallincubation time for the assay may be significantly reduced to less thanabout 12, 8, 6, 4, or 2 hours. In another embodiment, the time to resultof the Hunter assay may be reduced by performing the reaction at 37° C.

Hunter's Assay on DBS and DPS

Hunter's assays may be performed in a central laboratory on a driedblood spot (DBS) sample. To evaluate to efficacy of the dropletactuator-based Hunter assay on dried samples, plasma samples, freshblood and plasma from fresh blood were spotted on ⅛″ diameter filterpaper and air dried.

Frozen plasma samples (n=10 affected and n=10 normal) were thawed and1.4 μL of the sample was spotted onto filter paper and air dried forabout 3 hours. Each DBS was placed in a separate centrifuge tube andstored at −20° C.

Fresh whole blood was collected in a lithium heparin tube. Whole blood(3.1 μL) was spotted onto filter paper and air dried for about 3 hours.Plasma was prepared from the blood sample by centrifugation and spottedonto filter paper and air dried for about 3 hours. Each DBS and DPS wasplaced in a separate centrifuge tube.

Samples were extracted from the filter paper using water containingextraction buffer, which may include a surfactant, such as 0.1% Tween®20. Dried plasma spots from frozen plasma samples (n=10 affected andn=10 normal) and plasma obtained from fresh blood samples were extractedin 40 μL and 100 μL water containing 0.1% Tween® 20. DBS prepared fromfresh blood were extracted in 100 μL and 150 μL water containing 0.1%Tween® 20. All samples were incubated for 30 minutes with agitation. Thetubes were centrifuged to deposit the filter paper at the bottom of thetube and the sample extracts were transferred into sample reservoirs ona droplet actuator. All the extracts were assayed for MPS II (Hunter'ssyndrome) along with fresh plasma obtained from whole blood. The digitalmicrofluidic protocol for testing DBS and DPS samples was as describedin reference to FIGS. 6A and 6B. The data is shown in Table 2.

TABLE 2 Hunter Assay on DPS and DBS t = 8 Differ- # Sample t = 0 hrsence 1 Blank 58 89 31 2 Hunter Affected#10 DPS extracted in 40 μL 58 178119 3 Hunter Affected#10 DPS extracted in 100 μL 59 103 44 4 HunterNormal#10 DPS extracted in 40 μL 58 303 244 5 Hunter Normal#10 DPSextracted in 100 μL 56 341 284 6 Fresh DPS extracted in 40 μL 52 19381886 7 Fresh DPS extracted in 100 μL 53 704 650 8 Fresh DBS extracted in100 μL 49 744 694 9 Fresh DBS extracted in 150 μL 51 739 688 10 FreshPlasma diluted ¼x 56 6023 5967 11 Fresh Plasma diluted ¼x 56 8471 8415

The data from Table 2 clearly shows that there is separation between aHunter patient DPS and a normal DPS. The extracts from DPS and DBSprepared from fresh whole blood gave similar fluorescence values using100 μL extraction volumes. Assay on fresh plasma prepared from wholeblood and diluted 1:4 using water was used as a positive control. Thefluorescence signal obtained from fresh plasma was within the range asthe fluorescence signals obtained from plasma samples in FIGS. 6A and6B.

Effect of Temperature on Hunter Assay

To examine the effect of temperature on the Hunter assay, the assay(referring to the protocol of FIGS. 6A and 6B) was performed at 37° C.with an incubation time of 8 hours. Plasma samples were diluted 1:4 asdescribed in reference to FIGS. 6A and 6B. Archived DBS samples wereextracted in 150 μL of water containing 0.1% Tween® 20 as described inreference to Table 2. The data is shown in Table 3. A clear separationin fluorescence signal is observed between Hunter affected plasmasamples and normal plasma samples. The fluorescence signal from archivedDBS are also increased compared to Hunter affected samples and arecomparable to the signal from fresh DBS.

TABLE 3 Effect of Temperature On Hunter Assay Blank 31 Hunter AffectedPlasma sample#2 diluted ¼x 45 Hunter Affected Plasma sample#3 diluted ¼x34 Hunter Affected Plasma sample#4 diluted ¼x 108 Hunter Normal Plasmasample#2 diluted ¼x 2136 Hunter Normal Plasma sample#3 diluted ¼x 3761Hunter Normal Plasma sample#4 diluted ¼x 6878 Archived DBS (1230N)extracted in 150 μL 1084 Archived DBS (1240N) extracted in 150 μL 570Archived DBS (1299N) extracted in 150 μL 481 Fresh DBS extracted in 150μL 658Effect of Extraction Volume on Hunter Assay Using Dried Blood SpotExtracts

To examine the effect of extraction volume on the Hunter assay, archivednormal DBS (1264N, 1265N) and fresh normal DBS were extracted in 50,100, or 150 μL of water containing 0.1% Tween® 20. The samples wereanalyzed on a droplet actuator using a digital microfluidic protocol,such as the protocol of FIGS. 6A and 6B.

FIG. 7 shows a plot 700 of the effect of extraction volume on Hunterassay using DBS extracts. The data is shown in Table 4. The data showthat as the extraction volume is decreased (i.e., from 150 to 50 μL) therelative fluorescence signal of the sample increases. The increase insignal intensity may be due to an increase in the concentration ofiduronate-2-sulfate sulphatase (IDS) in the samples at lower extractionvolumes. In a preferred embodiment, about 100 μL extraction volume maybe used to prepare DBS extracts.

TABLE 4 Effect of DBS Extraction Volume on Hunter Assay Volume (μL)1264N 1265N Fresh DBS 150 590 892 553 100 807 1018 668 50 988 1403 815Enzyme Assays for Gaucher and Niemann-Pick Diseases

The invention provides assay methods for detection of Gaucher andNiemann-Pick diseases on a droplet actuator. Gaucher's disease andNiemann-Pick's disease are caused by deficient activity of the lysosomalenzymes acid β-D-glucosidase and acid sphingomyelinase, respectively. Inone embodiment, the invention provides methods for a droplet-basedenzymatic assay for acid β-D-glucosidase activity. For example, amultrifluoroethylumbelliferyl-β-D-glucoside, such as a4-pentafluoroethylumbelliferyl-β-D-glucoside, may be used as a substratefluid in a droplet-based enzymatic assay for acid β-D-glucosidase enzymeactivity. The increased number of fluorines makes the substrate fluidmore labile to hydrolysis. The excitation/emission wavelengths for4-pentafluoroethylumbelliferyl-β-D-glucoside are 385/495 nm. Whentesting for Gaucher's disease in a droplet actuator, the enzymaticactivity may, for example, be as much as eight-fold greater when usingthe 4-pentafluoroethylumbelliferyl-B-D-glucoside substrate fluidcompared with using the 4-methylumbelliferyl-β-D-glucoside substratefluid.

4MU fluid substrates may be replaced or supplemented with4-trifluoromethylumbelliferyl substrates. For example,4-trifluoromethylumbelliferyl glycosides may be used as substrates forthe assay of LSD hydrolyases (glycosidases, etc.). The4-trifluoromethylumbelliferone leaving group exhibits a greater signaland the signal is shifted more to the red when compared to4-methylumbelliferone. In addition, the 4-trifluoromethylumbelliferylglycosides may be cleaved more readily than the 4-methylumbelliferylglycosides leading to a larger signal.

In another embodiment, the invention provides methods for droplet-basedenzymatic assays for chitotriosidase activity. Chitotriosidase issignificantly increased in the plasma of patients with certainconditions, such as Gaucher's disease. In one example, chitotriosidaseactivity may be used as a surrogate plasma marker for a condition inwhich chitotriosidase activity is altered, such as Gaucher's disease. Inanother example, chitotriosidase activity may be used as a surrogateplasma marker for Niemann-Pick's disease. The substrate fluid forchitotriosidase in an enzymatic assay may, for example, be thefluorogenic substrate 4-trifluoromethylumbelliferylchitroside. Thesample for the enzymatic assay may, for example, be a plasma droplet ora dried blood extract droplet. Because chitotriosidase is increased inthe plasma of patients with Gaucher and Niemann-Pick diseases, there maybe a significant separation in the fluorescence signal between apatient's plasma sample and a normal plasma sample. The use ofchitotriosidase in may also reduce the number of tests that need to beperformed in a testing panel for lysosomal storage diseases.

An example of a testing assay for chitotriosidase activity may involve,but is not limited to, the following: A sample droplet (e.g., a driedblood extract droplet) is combined using droplet operations with asubstrate droplet (e.g., fluorogenic substrate4-trifluoromethylumbelliferylchitroside) droplet to form a 2× droplet.The 2× droplet is split using droplet operations to form two 1× reactiondroplets. One 1× reaction droplet is combined using droplet operationswith a stop buffer droplet. Fluorescence of the combined droplet ismeasured (t−0 hrs). The second 1× reaction droplet is incubated for apredetermined time and then the reaction droplet is combined with a stopbuffer droplet. End point fluorescence is measured (t−END hrs). In thisexample, a single sample droplet is dispensed and analyzed. However, anynumber of sample droplets may be dispensed and analyzed.

In another embodiment, droplet-based enzymatic assays forchitotriosidase activity may be combined with other droplet-basedenzymatic assays in a panel of tests used for a testing panel forlysosomal storage diseases.

Other embodiments may make use of the modified umbelliferyl substratesdescribed herein.

Enzyme Assay for Morquio B Syndrome

The invention provides assay methods for detection of the lysosomalstorage disorder Morquio B syndrome (mucopolysaccharidosis IV) on adroplet actuator. Morquio B syndrome is caused by deficient activity ofthe lysosomal enzyme β-galactosidase. The substrate fluid forβ-galactosidase in an enzymatic assay may, for example, be thefluorogenic substrate 4-methylumbelliferyl-β-galactose(4-MU-β-galactose; excitation 360 nm, emission 460 nm). The sample forthe enzymatic assay may, for example, be a plasma droplet or a driedblood extract droplet. Because β-galactosidase is deficient in patientswith Morquio B syndrome, there may be a significant separation in thefluorescence signal between a patient's blood sample and a normal bloodsample. A second enzyme that may be present in a blood sample,β-galactocerebrosidase, may also cleave the 4-MU-β-galactose substrate.However, levels of β-galactocerebrosidase are significantly lower (e.g.,about 200× lower) than levels of β-galactosidase.

On-bench assays for β-galactosidase activity in a blood sample may beadapted and described as discrete droplet-based protocols. One exampleof an on-bench assay for β-galactosidase activity includes the followingsteps:

-   -   1. A 250 mM stock solution of substrate (4-MU-β-galactose) was        diluted 10× in buffer (0.1 M citrate/0.2 M phosphate pH 4.6);    -   2. Add 4 μL 10× diluted substrate to 196 μL of buffer (0.1 M        citrate/0.2 M phosphate pH 4.6); Make a 25 mM stock in DMSO.        Final concentration: 0.5 mM.    -   3. Add 10 μL of the substrate to 10 μL of dried blood extract        and incubate at 37° C. for 21 hrs; and    -   4. Measure fluorescence at 360/460 nm at a gain of 50.

An example of a digital microfluidic testing assay for β-galactosidaseactivity may include, but is not limited to, the following: A sampledroplet (e.g., a dried blood extract droplet) is combined and mixedusing droplet operations with a Morquio B reagent (e.g.,4-MU-β-galactose) droplet to form a 2× reaction droplet. The 2× reactiondroplet is split using droplet operations to form two 1× reactiondroplets. One 1× reaction droplet is combined using droplet operationswith a stop buffer droplet. Fluorescence of the combined droplet ismeasured (t−0 hrs). The second 1× reaction droplet is incubated at acertain temperature (e.g., 37° C.) for a predetermined time and then thereaction droplet is combined with a stop buffer droplet. End pointfluorescence is measured (t−END hrs). In this example, a single sampledroplet is dispensed and analyzed. However, any number of sampledroplets may be dispensed and analyzed. B-galactosidase activity iscalculated from the difference of t−0 hrs from t−END hrs.

In another embodiment, droplet-based enzymatic assays forβ-galactosidase activity may be combined with other droplet-basedenzymatic assays in a panel of tests used for a testing panel forlysosomal storage diseases.

Other embodiments may make use of the modified umbelliferyl substratesdescribed herein.

Multiplexed Enzyme Assays on a Droplet Actuator

FIG. 8 illustrates a top view of an example of a droplet actuator 800that is suitable for use in conducting multiplexed enzymatic assays in anewborn testing protocol. Droplet actuator 800 includes multipledispensing reservoirs, which may, for example, be allocated as sampledispensing reservoirs 810 (e.g., 48 sample dispensing reservoirs 810)for dispensing sample fluids (e.g., dried blood spot extracts); one ormore reagent dispensing reservoirs 812 for dispensing different reagentfluids; one or more substrate fluid dispensing reservoirs 814 fordispensing substrate fluids; and one or more waste collection reservoirs816 for receiving waste droplets. Droplet actuator 800 is configured toperform 5-plex enzymatic assays on each sample, i.e., 5 enzymatic assayson each of 48 samples for a total of 240 assays.

Any of the enzymatic assay protocols described herein may be adapted foruse on a droplet actuator, e.g., for use in testing newborns forenzymatic disorders. In one example, enzymatic assays for Pompe andFabry diseases may be adapted and performed on a droplet actuator. FIG.9 shows an example of a plot 900 of multiplexed testing for Pompe andFabry diseases using extracts from single DBS punch. FIG. 9 shows clearseparation between the affected (enzyme deficient) and normal samplesfor both the Pompe assay and the Fabry assay. The assays werereproducibly performed on over 100 normal neonatal DBS samples and 20affected neonatal samples.

Other embodiments may make use of the modified umbelliferyl substratesdescribed herein.

Enzyme Assays for Biotinidase (BIOT) and Galactosemia

Assays for biotinidase and total galactose, for BIOT and galactosemiatesting, respectively, are currently available and performed by manynewborn testing (NBS) laboratories world-wide. The assay for biotinidasemay be the colorimetric Wolf's assay (absorbance detection assay). Theassay for total galactose is a fluorometric assay (365 nm excitation/465nm emission). The colorimetric assay for biotinidase and thefluorometric assay for total galactose may be adapted for use on adroplet actuator. In one embodiment, the invention provides on-chipenzyme assay protocols for newborn testing for BIOT and galactosemiausing a single punch from a DBS sample. DBS extracts may be preparedusing a single extraction buffer and exclusive components required foreach assay may be included in the reagent formulation. The on-chipenzyme assays are adapted for each enzymatic reaction and arereproducible. For example, different concentrations of analyte (e.g.,DBS punch extracted in about 50 μL or about 100 μL or about 150 μL orabout 200 μL of extraction buffer) may be selected such that a minimalamount of DBS extract provides a detectable signal. Because a minimalamount of DBS extract is used, multiple NBS assays may be performed. Theconcentrations of the different reagents, buffering capacity, and pH maybe adapted for use in a digital microfluidics protocol. Incubation timesfor each enzymatic reaction may be selected based on kinetic data. Therelatively large reaction volumes in the on-bench protocol may bereduced, i.e., unitized to droplet volumes that are compatible with adigital microfluidic format.

Other embodiments may make use of the modified umbelliferyl substratesdescribed herein.

Immunoassays for CH, CAH, and CF Testing

The invention provides on-chip immunoassay protocols for newborn testingfor congenital hypothyroidism (CH), congenital adrenal hyperplasia (CH),and cystic fibrosis (CF) using a single punch from a DBS sample. DBSextracts may be prepared using a single extraction buffer and exclusivecomponents required for each assay may be included in the reagentformulation.

In one embodiment, the invention provides on-chip immunoassay protocolsfor immunoreactive trysinogen (IRT) for CF. In another embodiment, theinvention provides on-chip immunoassay protocols for thyroid stimulatinghormone (TSH) and free thryroxine (T4) for CH. In yet anotherembodiment, the invention provides on-chip immunoassay protocols for17α-hydroxy progesterone (17-OHP) for CAH. The immunoassays for IRT andTSH are sandwich immunoassays. The immunoassays for 17-OHP and T4 arecompetitive assays.

In one embodiment, the enzyme label (labeled secondary antibody) for allon-chip immunoassays may be alkaline phosphatase (ALP). Detection may,for example, be fluorescence-based. The substrate fluid for ALP may, forexample, be 4-methylumbeliferrone phosphate (4-MUPi) withexcitation/emission wavelength of 365/460 nm. The on-chip immunoassaysmay be adapted for each enzymatic reaction. For example, differentconcentrations of analyte (e.g., DBS punch extracted in about 50 μL orabout 100 μL or about 150 μL of extraction buffer) may be selected suchthat a minimal amount of DBS extract provides a detectable signal.Because a minimal amount of DBS extract is used, multiple NBS assays maybe performed. The concentrations of the different reagents (e.g.,primary and secondary antibodies-labeled with ALP) may be adapted foruse in a digital microfluidics protocol. In one example, concentrationsof primary and secondary antibodies required for sufficient sensitivitymay be determined using antigen standards. Incubation times for eachimmunoassay may be selected based on binding kinetic data. Bindingincubations may, for example, be determined using a droplet mixingprotocol wherein the droplet mixture of reagents and the sample arecontinuously mixed on-chip to ensure substantially complete resuspensionof magnetically responsive beads with bound immune-complex thereon. Inanother example, fluorescence kinetic data for the reaction of 4-MUPiwith the washed magnetically responsive beads with bound immune-complexthereon may be used to select an incubation time sufficient for requiredsensitivity. Adsorption of proteins and other contaminating materialsfrom the DBS extract onto the magnetically responsive immunocapturebeads may be substantially eliminated by using suitable blockingsolutions and/or surfactants in the wash buffer. Exemplary protocols fordroplet-based immunoassays are set forth in Pamula, et al., U.S. Pat.No. 7,815,871, issued on Oct. 19, 2010, the entire disclosure of whichis incorporated herein by reference.

FIG. 10 shows an example of a plot 1000 of a standard curve for thyroidstimulating hormone (TSH). A reagent mixture that contains equal volumesof primary antibody that are bound to magnetically responsive beads(immunocapture beads), blocking solution, and secondary antibody labeledwith ALP was prepared on-bench. TSH standards were prepared on-bench.The digital microfluidic protocol associated with the TSH standard curveshown in plot 1000 included the following steps: One droplet of reagentmixture was mixed with two droplets of different concentrations of TSHstandards to form a reaction droplet. The reaction droplet was incubatedfor 4 minutes. Magnetically responsive beads with bound immunocomplexesthereon were washed using a bead washing protocol to remove any unboundsecondary antibody. One droplet of chemiluminescent substrate fluid wascombined using droplet operations with the reaction droplet andincubated for 2 minutes. End point chemiluminescence was measured usinga photon counting photomultiplier tube. A 4-parameter logistic fit wasused to fit the data. The error bars represent standard deviation fromfour different assays. Cut-off concentration for TSH that is used bymost newborn testing laboratories in the US is 20 μl U/mL.

Other embodiments may make use of the modified umbelliferyl substratesdescribed herein.

Integrated Droplet Actuator Device

Newborn testing may be performed in centralized laboratories and oftenrequires different types of assays for different conditions. Forexample, immunoassays may be used to test for congenital hypothyroidism(CH), congenital adrenal hyperplasia (CAH) and cystic fibrosis (CF) andenzymatic assays are used to test for biotinidase deficiency (BIOT) andgalactosemia. Current technologies used in testing for these conditionsuse separate instrumentation. For example, most newborn testinglaboratories use Perkin Elmer's Autodelfia immunoanalyzer to test forCF, CH, and CAH and Astoria Pacific's Spotcheck (fluorescence basedanalyzer) to test for galactosemia. Other laboratories may use a manualfluorometric method to test for galactosemia. To test for BIOT, mostnewborn testing laboratories use a manual colorimetric assay (e.g.,Wolf's assay) in a 96-well format. Because separate assays andinstrumentation are used, precious neonatal sample volume is notconserved.

The invention provides an integrated droplet actuator device and methodsfor performing enzymatic assays and immunoassays on a single dropletactuator. In one example, the integrated droplet actuator device andmethods of the invention may be used for multiplexed detection of CAH,CH, CF, galactosemia, and BIOT using, for example, extract from a singledried blood spot sample.

FIG. 11 illustrates a top view of an example of a droplet actuator 1100that is suitable for use in conducting an integrated enzyme assay andimmunoassay newborn testing protocol. Droplet actuator 1100 includesmultiple dispensing reservoirs, which may, for example, be allocated assample dispensing reservoirs 1110 (e.g., 12 sample dispensing reservoirs1110) for dispensing sample fluids (e.g., dried blood spot extracts);reagent dispensing reservoirs 1112 (e.g., 8 reagent dispensingreservoirs 1112) for dispensing different reagent fluids; a wash bufferdispensing reservoir 1114 for dispensing wash buffer fluids; one or morewaste collection reservoirs 1116 (e.g., waste collection reservoirs 1116a and 1116 b) for receiving waste droplets; and a substrate fluiddispensing reservoir 1118 for dispensing substrate fluids. In oneexample, two reagent dispensing reservoirs 1112 may be used to dispensereagents for a CAH immunoassay (e.g., 17-OHP); one reagent dispensingreservoir 1112 may be used to dispense reagents for a BIOT enzyme assay;one reagent dispensing reservoir 1112 may be used to dispense reagentsfor a galactosemia enzymatic assay; two reagent dispensing reservoirs1112 may be used to dispense reagents for a CR immunoassay (e.g., IRT);and two reagent dispensing reservoirs 1112 may be used to dispensereagents for a CH immunoassay (e.g., TSH/T4). Substrate fluid dispensingreservoir 1118 may be used to dispense a fluorogenic substrate fluid,such as 4-MUPi, for fluorescence-based immunoassays. Sample dispensingreservoirs 1110, reagent dispensing reservoirs 1112, wash bufferdispensing reservoir 1114, waste collection reservoirs 1116, andsubstrate fluid dispensing reservoir 1118 are aligned with dispensingelectrodes and interconnected through an arrangement, such as a path orarray, of droplet operations electrodes 1120 (e.g., electrowettingelectrodes). Droplet operations are conducted atop droplet operationselectrodes 1120 on a droplet operations surface.

Droplet actuator 1100 may include an enzymatic assay zone 1122 (e.g., a2-plex enzymatic assay zone) for performing enzymatic assays such asenzymatic assays for BIOT and galactosemia. Droplet actuator 1100 mayfurther include an immunoassay zone 1124 (e.g., a 3-plex immunoassayzone) for performing immunoassays such as immunoassays for CH, CAH andCF. Droplet actuator 1100 may further include a detection zone 1126.Detection zone 1126 may include certain areas for detection of afluorescent signal and certain areas for absorbance detection asdescribed in reference to FIG. 12.

FIG. 12 illustrates a side view of an example of a detection system 1200for simultaneous fluorescence and absorbance detection of multipledroplets on a single droplet actuator. The detection system of theinvention includes a detector to measure absorbance for colorimetricassays and a sensitive fluorimeter for low level (e.g., about 0.55 nM of4-MU) fluorescence detection.

Detection system 1200 may include an imaging device 1210 and a detector1212. Imaging device 1210 may, for example, be a sensitive fluorimeter.Detector 1212 may include an arrangement of light emitting diodes (LEDs)1214, e.g., three LEDs 1214 a, 1214 b and 1214 c, and an arrangement ofphotodetectors 1216, e.g., three photodetectors 1216 a, 1216 b, and 1216c. Photodetectors 1216 may, for example, be photodiodes. The arrangementof LEDs 1214 and photodetectors 1216 is such that photodetectors 1216are substantially aligned with LEDs 1214. Detection system 1200 is partof an instrument (not shown) used for operation of a droplet actuator.

A droplet actuator may be used in combination with detection system1200. For example, a droplet actuator 1218 may be positioned in aninstrument deck (not shown) such that a certain region of dropletactuator 1218 is aligned with detection system 1200. Droplet actuator1218 may include a bottom substrate 1220 and a top substrate 1222 thatare separated by a gap 1224. A gasket 1226 may be used to set the sizeof gap 1224. Bottom substrate 1220 may include an arrangement of dropletoperations electrodes 1228 (e.g., electrowetting electrodes). Dropletoperations are conducted atop droplet operations electrodes 1228 on adroplet operations surface.

Droplet actuator 1218 is positioned in an instrument deck (not shown)such that imaging device 1210 and detector 1212 are aligned with certaindroplet operations electrodes 1228. In particular, LEDs 1214 andphotodetectors 1216 are substantially aligned with certain dropletoperations electrodes 1228.

Droplet actuator 1218 may include a droplet 1230. Droplet 1230 may, forexample, be a droplet of sample fluid to be evaluated. Droplet 1230 may,for example, have a volume of about 300 nL. In one example, droplet 1230may contain a quantity of beads (not shown). For example, the beads maybe immunocapture beads for targeting a certain substance (e.g., protein,DNA, and/or antigens) during the assay operations (i.e., immunoassay) ofdroplet actuator 1218. Upon interacting with a reagent, droplet 1230 maybe evaluated for target substances that have an affinity for theimmunocapture beads therein. One example method of evaluation may be bydigital imaging for identifying, for example, a fluorescent signal. Inanother example, droplet 1230 may contain a quantity of fluorescentreaction product generated during an enzymatic assay, such as an assayused to test for galactosemia.

In operation, imaging device 1210 is substantially aligned with acertain droplet operations electrode 1228, such that the certain dropletoperations electrode 1228 is within the imaging field of imaginingdevice 1210. Imaging device 1210 may be used to capture images (e.g.,fluorescent signal) that may be emitted from droplet 1230. Imagingdevice 1210 may capture images through top substrate 1222, which may,for example, be a glass plate that is substantially transparent.Further, the thickness of top substrate 1222 may be optimized to provideeffective imaging of droplet 1230.

Droplet actuator 1218 may further include one or more droplets 1232(e.g., droplets 1232 a, 1232 b, and 1232 c) to be evaluated. Eachdroplet 1232 may, for example, have a volume of about 300 nL. Droplets1232 may, for example, contain a quantity of reaction product generatedduring an enzymatic assay, such as a colorimetric assay used to test forBIOT. One example method of evaluation may be by absorbance detection ofa colored reaction product.

All operations to multiplex enzymatic assays and immunoassays on adroplet actuator may be programmed in the software for controlling thedroplet actuator. In one example, software that converts complex assayprotocols into simple flow charts may be used to provide input commandsfor the electronics of the droplet actuator.

An example of multiplex testing assay protocol may include, but is notlimited to, the following: Dispense five sample droplets (e.g.,extracted from a single DBS punch) and transport the droplets usingdroplet operations to the appropriate reaction zones (e.g., enzymaticassay zone or immunoassay zone). For an enzymatic assay (e.g.,galactosemia, BIOT), dispense one droplet of reagent and combine itusing droplet operations with one sample droplet to form a reactiondroplet. Incubate the reaction droplet for a period of time sufficientfor generation of a reaction product. Dispense one droplet ofstop/quench buffer and combine it using droplet operations with thereaction droplet. Detect fluorescence (e.g., galactosemia assay) orabsorbance (e.g., BIOT assay). For sandwich immunoassays (e.g., CF, CH),dispense one droplet each of magnetically responsive immunocapturebeads, blocking solution and secondary antibody labeled with ALP. Mergeall the droplets (reagent droplets and sample droplet) using dropletoperations and incubate for a period of time sufficient for formation ofimmunocomplexes. Magnetically responsive beads with boundimmunocomplexes thereon are washed using a bead washing protocol toremove any unbound secondary antibody. Dispense one droplet of substratefluid, e.g., 4-MUPi, and combine it using droplet operations with thewashed bead droplet. Detect fluorescence. For competitive immunoassays(e.g., CH and CAH), dispense on droplet of magnetically responsiveimmunocapture beads and combine it using droplet operations with onesample droplet and one droplet of ALP-labeled analyte to form a reactiondroplet. Incubate the reaction droplet for a period of time sufficientfor antigen-antibody binding Magnetically responsive beads are washedusing a bead washing protocol to remove excess material. Dispense onedroplet of substrate fluid, e.g., 4-MUPi, and combine it using dropletoperations with the washed bead droplet. Detect fluorescence.

Reducing Contamination

In newborn testing assays, contamination may be caused by liquidhandling failures, such as droplet splitting, or pinning of previousdroplets on the same electrode pathway. Contamination may cause falsenegatives for one or more droplets on the contaminated pathway. In oneembodiment, contamination is avoided by using stop buffer droplets towash the previous lane. Examples of stop buffers are those often used inenzymatic assays, such as newborn testing assays for metabolicdisorders. Examples of lane or pathway washing protocols are describedin International Patent Application No. PCT/US09/43774, entitled DropletActuator Devices, Systems, and Methods, filed on May 13, 2009, theentire disclosure of which is incorporated herein by reference.

As an example, wash droplets may be transported along a common pathwaybetween each potentially contaminating droplet. The potentiallycontaminating droplet may include a reagent droplet, a sample droplet,and/or a reaction droplet that includes a potentially contaminatingsubstance, such as a target enzyme. The wash droplets may, for example,include a wash buffer, such as a stop buffer. Wash droplets may includecompounds that degrade contaminants. Wash droplets may includecomponents that bind to contaminants Wash droplets may be transportedalong the common pathway in the same direction or in an opposite, ortransverse direction relative to the potentially contaminating droplets.In some cases, multiple wash droplets are interposed on paths betweenpotentially contaminating droplets. In some cases, the wash droplets arelarger than the potentially contaminating droplets, e.g., 2×, 3×, 4× orlarger droplets may be used as wash droplets.

Immobilization of 4-Methylumbelliferone (4-MU)

4-MU-containing substrates (a.k.a 7-hydroxy 4-methylcoumarin) are usedin a number of bioassays, including assays for the detection oflysosomal storage disorders in newborns. The fluorometric enzyme assaysare based on the hydrolysis of a 4-MU-containing substrate by a specificenzyme to yield the fluorescent molecule 4-MU. In the droplet operationsenvironment of a droplet actuator, partitioning of 4-MU between theaqueous phase (i.e., droplet) and the organic phase (filler fluid) maypotentially contaminate an electrode pathway. The enzymatic turnover ofthe 4-MU substrate requires a low-pH environment (acidic environment).At low pH (pK of 4-MU=7.9), 4-MU is non-ionic and hydrophobic andpartitions preferentially from the aqueous droplet phase into the oilfiller phase (100:1). Droplets subsequently prepared for the detectionstep of the bioassay are at a high pH. Fluorescence of 4-MU is optimalat elevated pH (pH>10). A high pH (pH>10) facilitates reversepartitioning of 4-MU from the oil phase back into an aqueous phasedroplet. The potential for droplet cross-contamination is problematicwhen an acidic droplet with elevated enzyme concentration (producingsignificant amounts of 4-MU product) is in proximity of a basic dropletwith substantially lower 4-MU concentrations.

The invention provides methods to substantially eliminatecross-contamination between droplets or loss of signal from droplets in4-MU-based bioassays (e.g., newborn testing assays) on a dropletactuator. The method provides significantly improved discriminationbetween a positive signal and a negative signal in 4-MU-based bioassays.In one embodiment, the enzymatic 4-MU-containing substrate may beimmobilized onto a solid support. In another example the enzymatic4-MU-containing substrate may be immobilized on magnetically responsivebeads. In yet another example, the enzymatic 4-MU-containing substratemay be immobilized on hydrogel beads. The 4-MU-containing substrate may,for example, be immobilized onto a solid support via the 4-MU componentof the substrate molecule. The solid support (e.g., magneticallyresponsive beads or hydrogel beads) may be selected such that the beadsremain suspended in an aqueous droplet and move with the aqueous dropletduring droplet operations Immobilization of the 4-MU onto a solidsupport (e.g., magnetically responsive beads or hydrogel beads) providesfor retention of the enzymatic 4-MU substrate within the aqueous dropletand substantially eliminates partitioning of 4-MU into the oil fillerphase at any pH Immobilization of 4-MU may also occur ontomacromolecules, such as cellulose.

In another embodiment, enzymatic substrates, such as 4-MU-containingsubstrates, may be retained within an aqueous phase (e.g., an aqueousdroplet) by formation of an “inclusion complex.” In one example,cyclodextrins may be used to form an inclusion complex containing 4-MU.Cyclodextrins are donut-shaped cyclic glucose molecules with ahydrophobic inner cavity and a hydrophilic outer surface. Cyclodextrinsare commercially available in various sizes. For example,alpha-cyclodextrins have 6 glucose units, β-cyclodextrins have 7 glucoseunits and gamma-cyclodextrins have 8 glucose units. The size of theinner cavity increases from alpha-cyclodextrin to gamma-cyclodextrin.Alternatives to cyclodextrins may include crown ethers, cryptands, andcyclic peptides, as well as derivatives, conjugates, and combinations ofthe foregoing, and may be used in other embodiments described herein.

FIG. 13 shows a diagram of an on-bench assay protocol 1300 forevaluating the effect of additives (e.g., β-cyclodextrins, surfactants)on 4-MU partitioning. The assay format includes forward transferpartitioning (forward extraction; FE) of 4-MU from an aqueous phase toan oil phase and backward transfer partitioning (backward extraction;BE) of 4-MU from an oil phase to an aqueous phase. The assay isperformed in 96-well microtiter substrates; clear 96-well substrates(e.g., Costar 3631) for evaluation of forward transfer partitioning withbottom probe fluorescence detection and solid black 96-well substrates(e.g., Costar 3915) for evaluation of backward transfer partitioningwith top probe fluorescence detection. A BioTek Synergy HT instrumentwith 3 mm top probe and 5 mm bottom probe, may, for example, be used forfluorescence measurements. In one example, parameters that may be variedin the assay for evaluation of cyclodextrins in aqueous containment of4-MU include, but are not limited to, ionic strength of the aqueousphase solution, pH of the aqueous phase solution (e.g., pH 2 or pH 5),and the molar ratio of cyclodextrins to 4-MU.

An example of an assay format used for testing the effect ofcyclodextrins on contamination through 4-MU partitioning includes, butis not limited to, the following steps: Pipette an aliquot (20 μL) of anaqueous phase solution (e.g., at pH 2, pH5 or pH 10.5) containing asurfactant, such as 0.01% Tween® 20 in a well of a 96-well clearmicrotiter plate. The aqueous phase solution may also include 4-MU(e.g., 100 μM), NaCl (e.g., 50 mM), and β-cylcodextrin (e.g., 100 μM, 1mM, 10 mM, or 100 mM). Add 130 μL of silicone oil (5 cSt, 0.1% TritonX-15) to each well that contains an aqueous phase droplet. Seal theplate with aluminum foil and shake using a bench top shaker (e.g.,Thermofisher shaker at speed setting 5) for 30 min at room temperature.Carefully remove the aluminum foil and observe each well to note andrecord any defects in droplet quality (minimize light exposure duringthis step). Measure the fluorescence of each well using a bottom probeat gains 40, 45, and 50. Transfer, without disturbing the aqueousdroplet, 50 μL of the oil phase (FE oil) from each well into therespective well of a solid black microtiter plate that contains 50 μL of200 mM NaHCO₃ in each well. Seal the plate with aluminum foil and shakeusing, for example, a Thermofisher bench top shaker (e.g., speed setting5) for 30 min at room temperature. Remove the aluminum foil and measurethe fluorescence of each well using a top probe at gains 50, 60, 70, and80.

Aqueous containment of 4-MU may be examined as a function of the molarratio of β-cyclodextrin to 4-MU. FIGS. 14A and 14B show a plot 1400(linear-linear scale) and a plot 1450 (log-log scale), respectively, ofconcentration free 4-MU as a function of β-cyclodextrin:4-MU molarratio. The data was generated at pH 2 in 100 mM KCl, MeOH/water 2/98v/v.

FIG. 15 shows a plot 1500 of an expected BE signal (back extraction) asa function of free 4-MU concentration at equilibrium in FE (forwardextraction). Relative fluorescence was measured at gain 70. The molarratio of β-cyclodextrin to 4-MU was 0:1 to 200:1.

FIGS. 16A through 16G show screenshots of an example of an experimentdesigned to evaluate the effect of cyclodextrins, pH and ionic strengthon aqueous containment of 4-MU. Referring to FIG. 16D, the lowestcontamination signal (A) was achieved at a molar ratio of Me-bCD to 4-MUof 200:1 compared to the corresponding background signal (B). Theexperiment demonstrates that β-cyclodextrins(methyl-β-cyclodextrin,hydroxypropyl-β-cyclodextrin) are effective in aqueous containment of4-MU. The effect of β-cyclodextrin on the aqueous containment of 4-MU isindependent of pH. A large molar excess of β-cyclodextrin to 4-MU(e.g., >1,000:1) may be required for favorable equilibrium shiftparticularly when the initial 4-MU concentration is low.

Tables 5 and 6 show an example of a microtiter plate layout used toevaluate the effect of cyclodextrins (CD) on aqueous containment of4-MU. The plate layout for forward transfer partitioning is shown inTable 5. In this example, the pH of the aqueous phase was pH 2 or pH 5.The concentrations of β-cyclodextrins were 100 μM, 10 mM, or 100 mM. Theconcentration of 4-MU is either 0 μM or 100 μM.

TABLE 5 Plate layout (n = 4 reps) for forward transfer 1 2 3 4 5 6 7 8 910 11 12 A 20 μL_0 μM@pH 2_CD1 20 μL_0 μM@pH 5_CD1 20 μL_0 μM@pH 2_CD2130 μL oil (5 cSt, 0.1% Tx15) 130 μL oil (5 cSt, 0.1% Tx15) 130 μL oil(5 cSt, 0.1% Tx15) B 20 μL_100 μM@pH 2_CD1 20 μL_100 μM@pH 5_CD1 20μL_100 μM@pH 2_CD2 130 μL oil (5 cSt, 0.1% Tx15) 130 μL oil (5 cSt, 0.1%Tx15) 130 μL oil (5 cSt, 0.1% Tx15) C 20 μL_0 μM@pH 5_CD2 20 μL_0 μM@pH2_CD3 20 μL_0 μM@pH 5_CD3 130 μL oil (5 cSt, 0.1% Tx15) 130 μL oil (5cSt, 0.1% Tx15) 130 μL oil (5 cSt, 0.1% Tx15) D 20 μL_100 μM@pH 5_CD2 20μL_100 μM@pH 2_CD3 20 μL_100 μM@pH 5_CD3 130 μL oil (5 cSt, 0.1% Tx15)130 μL oil (5 cSt, 0.1% Tx15) 130 μL oil (5 cSt, 0.1% Tx15) E 20 μL_0μM@pH 2_CD4 20 μL_0 μM@pH 5_CD4 20 μL_0 μM@pH 2_CD5 130 μL oil (5 cSt,0.1% Tx15) 130 μL oil (5 cSt, 0.1% Tx15) 130 μL oil (5 cSt, 0.1% Tx15) F20 μL_100 μM@pH 2_CD4 20 μL_100 μM@pH 5_CD4 20 μL_100 μM@pH 2_CD5 130 μLoil (5 cSt, 0.1% Tx15) 130 μL oil (5 cSt, 0.1% Tx15) 130 μL oil (5 cSt,0.1% Tx15) G 20 μL_0 μM@pH 5_CD5 EMPTY EMPTY 130 μL oil (5 cSt, 0.1%Tx15) H 20 μL_100 μM@pH 5_CD5 EMPTY EMPTY 130 μL oil (5 cSt, 0.1% Tx15)*CD1 = 100 μM methyl-β-cyclodextrin; CD2 = 10 mM methyl-β-cyclodextrin;CD3 = 100 mM methyl-β-cyclodextrin; CD4 = 100 μMhydroxylpropyl-β-cyclodextrin; CD5 = 100 mMhydroxylpropyl-β-cyclodextrin

The corresponding microtiter plate layout for the backward transfer(backward extraction) is shown in Table 6. Each well of the secondmicrotiter plate (i.e., a solid black microtiter plate) contains 50 μLof an aqueous solution (200 mM NaHCO₃) at pH 10.5. Each well alsocontains an aliquot (50 μL) of oil (i.e., FE oil) from the correspondingwell of the forward transfer reaction described in reference to Table 5.For fluorescence calibration, an aqueous solution containing 4-MU (0,0.01, 0.1, or 1 μM) was added to the corresponding “empty” wells ofTable 5 and overlaid with a 50 μL aliquot of fresh oil.

TABLE 6 Plate layout (n = 4 reps) for backward transfer 1 2 3 4 5 6 7 89 10 11 12 A 50 μL_0 μM@pH 10.5_no S or CD 50 μL_0 μM@pH 10.5_no S or CD50 μL_0 μM@pH 10.5_no S or CD 50 μL FE oil (5 cSt, 0.1% Tx15) 50 μL FEoil (5 cSt, 0.1% Tx15) 50 μL FE oil (5 cSt, 0.1% Tx15) B 50 μL_0 μM@pH10.5_no S or CD 50 μL_0 μM@pH 10.5_no S or CD 50 μL_0 μM@pH 10.5_no S orCD 50 μL FE oil (5 cSt, 0.1% Tx15) 50 μL FE oil (5 cSt, 0.1% Tx15) 50 μLFE oil (5 cSt, 0.1% Tx15) C 50 μL_0 μM@pH 10.5_no S or CD 50 μL_0 μM@pH10.5_no S or CD 50 μL_0 μM@pH 10.5_no S or CD 50 μL FE oil (5 cSt, 0.1%Tx15) 50 μL FE oil (5 cSt, 0.1% Tx15) 50 μL FE oil (5 cSt, 0.1% Tx15) D50 μL_0 μM@pH 10.5_no S or CD 50 μL_0 μM@pH 10.5_no S or CD 50 μL_0μM@pH 10.5_no S or CD 50 μL FE oil (5 cSt, 0.1% Tx15) 50 μL FE oil (5cSt, 0.1% Tx15) 50 μL FE oil (5 cSt, 0.1% Tx15) E 50 μL_0 μM@pH 10.5_noS or CD 50 μL_0 μM@pH 10.5_no S or CD 50 μL_0 μM@pH 10.5_no S or CD 50μL FE oil (5 cSt, 0.1% Tx15) 50 μL FE oil (5 cSt, 0.1% Tx15) 50 μL FEoil (5 cSt, 0.1% Tx15) F 50 μL_0 μM@pH 10.5_no S or CD 50 μL_0 μM@pH10.5_no S or CD 50 μL_0 μM@pH 10.5_no S or CD 50 μL FE oil (5 cSt, 0.1%Tx15) 50 μL FE oil (5 cSt, 0.1% Tx15) 50 μL FE oil (5 cSt, 0.1% Tx15) G50 μL_0 μM@pH 10.5_no S or CD 50 μL_0 μM@pH 10.5_no S or CD 50 μL_0.01μM@pH 10.5_no S or CD 50 μL FE oil (5 cSt, 0.1% Tx15) 50 μL fresh oil (5cSt, 0.1% Tx15) 50 μL fresh oil (5 cSt, 0.1% Tx15) H 50 μL_0 μM@pH10.5_no S or CD 50 μL_0.1 μM@pH 10.5_no S or CD 50 μL_1 μM@pH 10.5_no Sor CD 50 μL FE oil (5 cSt, 0.1% Tx15) 50 μL fresh oil (5 cSt, 0.1% Tx15)50 μL fresh oil (5 cSt, 0.1% Tx15) “no S or CD” means no surfactant orβ-cyclodextrin

FIGS. 17A and 17B show data tables 1700 and 1750, respectively, offluorescence readings for forward transfer and backward transfer,respectively, of the 4-MU partitioning assay of Tables 5 and 6. Theforward transfer fluorescence (FIG. 17A) was read at a gain of 45 andthe backward transfer fluorescence (FIG. 17B) was read at a gain of 70.Referring to FIG. 17B, value V1 corresponds to cell B1, 2, 3, 4 of Table5, value V2 corresponds to cell D5, 6, 7, 8 of Table 5, value V3corresponds to cell F9, 10, 11, 12 of Table 5, and value V4 correspondsto cell H1, 2, 3, 4. The data show that at higher concentrations of CD,i.e., 100 mM (b-cyclodextrin:4-MU molar ratio>>200:1), forward transferof 4-MU from the aqueous phase to the oil phase is significantlyreduced.

FIGS. 18A and 18B show data tables 1800 and 1850, respectively, ofanother example of a 4-MU partitioning assay. The microtiter platelayouts for forward and backward transfer are shown in Tables 7 and 8,respectively, which are below. In this example, the concentration of4-MU was 10 μM. Forward transfer (FIG. 18A) was read at a gain of 45 andthe backward transfer (FIG. 18B) was read at a gain of 70. Referring toFIG. 18B, value V1 corresponds to cell B1, 2, 3, 4 of Table 7, value V2corresponds to cell D5, 6, 7, 8 of Table 7, and value V3 corresponds tocell F1, 2, 3, 4 of Table 7. The data show that at higher concentrationsof cyclodextrin, i.e., 100 mM (b-cyclodextrin:4-MU molar ratio>>200:1),forward transfer of 4-MU from the aqueous phase to the oil phase issignificantly reduced.

TABLE 7 Plate layout (n = 4 reps) for forward transfer 1 2 3 4 5 6 7 8 910 11 12 A 20 μL_0 μM@pH 2_CD1 20 μL_0 μM@pH 5_CD1 20 μL_0 μM@pH 2_CD2130 μL oil (5 cSt, 0.1% Tx15) 130 μL oil (5 cSt, 0.1% Tx15) 130 μL oil(5 cSt, 0.1% Tx15) B 20 μL_10 μM@pH 2_CD1 20 μL_10 μM@pH 5_CD1 20 μL_10μM@pH 2_CD2 130 μL oil (5 cSt, 0.1% Tx15) 130 μL oil (5 cSt, 0.1% Tx15)130 μL oil (5 cSt, 0.1% Tx15) C 20 μL_0 μM@pH 5_CD2 20 μL_0 μM@pH 2_CD320 μL_0 μM@pH 5_CD3 130 μL oil (5 cSt, 0.1% Tx15) 130 μL oil (5 cSt,0.1% Tx15) 130 μL oil (5 cSt, 0.1% Tx15) D 20 μL_10 μM@pH 5_CD2 20 μL_10μM@pH 2_CD3 20 μL_10 μM@pH 5_CD3 130 μL oil (5 cSt, 0.1% Tx15) 130 μLoil (5 cSt, 0.1% Tx15) 130 μL oil (5 cSt, 0.1% Tx15) E 20 μL_0 μM@pH2_CD4 20 μL_0 μM@pH 5_CD4 20 μL_0 μM@pH 2_CD5 130 μL oil (5 cSt, 0.1%Tx15) 130 μL oil (5 cSt, 0.1% Tx15) 130 μL oil (5 cSt, 0.1% Tx15) F 20μL_10 μM@pH 2_CD4 20 μL_10 μM@pH 5_CD4 20 μL_10 μM@pH 2_CD5 130 μL oil(5 cSt, 0.1% Tx15) 130 μL oil (5 cSt, 0.1% Tx15) 130 μL oil (5 cSt, 0.1%Tx15) G 20 μL_0 μM@pH 5_CD5 EMPTY EMPTY 130 μL oil (5 cSt, 0.1% Tx15) H20 μL_10 μM@pH 5_CD5 EMPTY EMPTY 130 μL oil (5 cSt, 0.1% Tx15) *CD1 = 10μM methyl-β-cyclodextrin; CD2 = 1 mM methyl-β-cyclodextrin; CD3 = 10 mMmethyl-β-cyclodextrin; CD4 = 100 mM methyl-β-cyclodextrin; CD5 = 100 mMhydroxylpropyl-β-cyclodextrin

TABLE 8 Plate layout (n = 4 reps) for backward transfer 1 2 3 4 5 6 7 89 10 11 12 A 50 μL_0 μM@pH 10.5_no S or CD 50 μL_0 μM@pH 10.5_no S or CD50 μL_0 μM@pH 10.5_no S or CD 50 μL FE oil (5 cSt, 0.1% Tx15) 50 μL FEoil (5 cSt, 0.1% Tx15) 50 μL FE oil (5 cSt, 0.1% Tx15) B 50 μL_0 μM@pH10.5_no S or CD 50 μL_0 μM@pH 10.5_no S or CD 50 μL_0 μM@pH 10.5_no S orCD 50 μL FE oil (5 cSt, 0.1% Tx15) 50 μL FE oil (5 cSt, 0.1% Tx15) 50 μLFE oil (5 cSt, 0.1% Tx15) C 50 μL_0 μM@pH 10.5_no S or CD 50 μL_0 μM@pH10.5_no S or CD 50 μL_0 μM@pH 10.5_no S or CD 50 μL FE oil (5 cSt, 0.1%Tx15) 50 μL FE oil (5 cSt, 0.1% Tx15) 50 μL FE oil (5 cSt, 0.1% Tx15) D50 μL_0 μM@pH 10.5_no S or CD 50 μL_0 μM@pH 10.5_no S or CD 50 μL_0μM@pH 10.5_no S or CD 50 μL FE oil (5 cSt, 0.1% Tx15) 50 μL FE oil (5cSt, 0.1% Tx15) 50 μL FE oil (5 cSt, 0.1% Tx15) E 50 μL_0 μM@pH 10.5_noS or CD 50 μL_0 μM@pH 10.5_no S or CD 50 μL_0 μM@pH 10.5_no S or CD 50μL FE oil (5 cSt, 0.1% Tx15) 50 μL FE oil (5 cSt, 0.1% Tx15) 50 μL FEoil (5 cSt, 0.1% Tx15) F 50 μL_0 μM@pH 10.5_no S or CD 50 μL_0 μM@pH10.5_no S or CD 50 μL_0 μM@pH 10.5_no S or CD 50 μL FE oil (5 cSt, 0.1%Tx15) 50 μL FE oil (5 cSt, 0.1% Tx15) 50 μL FE oil (5 cSt, 0.1% Tx15) G50 μL_0 μM@pH 10.5_no S or CD 50 μL_0 μM@pH 10.5_no S or CD 50 μL_0.01μM@pH 10.5_no S or CD 50 μL FE oil (5 cSt, 0.1% Tx15) 50 μL fresh oil (5cSt, 0.1% Tx15) 50 μL fresh oil (5 cSt, 0.1% Tx15) H 50 μL_0 μM@pH10.5_no S or CD 50 μL_0.1 μM@pH 10.5_no S or CD 50 μL_1 μM@pH 10.5_no Sor CD 50 μL FE oil (5 cSt, 0.1% Tx15) 50 μL fresh oil (5 cSt, 0.1% Tx15)50 μL fresh oil (5 cSt, 0.1% Tx15) “no S or CD” means no surfactant orβ-cyclodextrin

In the droplet operations environment of a droplet actuator, formationof an inclusion complex between 4-MU and cyclodextrins may be used tosubstantially minimize droplet cross-contamination by preventing 4-MUfrom leaking from the aqueous phase into the filler fluid (e.g.,silicone oil) phase at low pH. In one example, cyclodextrin may be usedas an additive to a reagent droplet that includes the 4-MU-containingsubstrate. A sample droplet (e.g., a dried blood extract droplet) iscombined and mixed using droplet operations with the reagent droplet.Because cyclodextrin is included in the reagent droplet, the enzymaticproduct, i.e., 4-MU, is sequestered within an inclusion complex as soonas it is released by the enzyme present in the sample droplet.

In yet another embodiment, surfactants may be used to retain 4-MU (orderivatives) within an aqueous phase (e.g., an aqueous phase droplet).The efficacy of different surfactants in containing 4-MU (orderivatives) within an aqueous phase may, for example, be evaluated andselected using a partitioning assay, such as the 4-MU partitioning assaydescribed in reference to FIG. 13. In this example, parameters that maybe varied in the assay for evaluation of surfactants in aqueouscontainment of 4-MU (or derivatives) include, but are not limited to,the pH of the aqueous phase solution (e.g. pH 2 to pH 10.5 range), andthe critical micellar concentration of the surfactant.

An example of an assay format used for testing the effect of surfactantson contamination through 4-MU partitioning includes, but is not limitedto, the following steps: Pipette an aliquot (20 μL) of an aqueous phasesolution (e.g., pH range of pH 2 to pH 10.5) containing a selectedconcentration (e.g., 1.5× the surfactant's critical micellarconcentration) of a surfactant in a well of a 96-well clear bottommicrotiter plate (e.g., Costar® 3631). The aqueous phase solution alsoincludes 4-MU (e.g., 1 mM). Add 130 μL of silicone oil (5 cSt, 0.1%Triton™ X-15) to each well that contains an aqueous phase droplet. Sealthe plate with aluminum foil and shake using a bench top shaker (e.g.,Thermofisher shaker at speed setting 5) for 30 min at room temperature.Carefully remove the aluminum foil and observe each well to note andrecord any defects in droplet quality (minimize light exposure duringthis step). Measure the fluorescence of each well using a bottom probeat, for example, a gain of 40. Transfer, without disturbing the aqueousdroplet, 50 μL of the oil phase (FE oil) from each well into therespective well of a solid black microtiter plate that contains 50 μL of200 mM NaHCO₃ pH 10.5 in each well. Seal the plate with aluminum foiland shake using, for example, a Thermofisher bench top shaker (e.g.,speed setting 5) for 30 min at room temperature. Remove the aluminumfoil and measure the fluorescence of each well using a top probe atgains 45, 50, 55, 60, 65, and 70.

FIG. 19 shows a data table 1900 of relative fluorescence readings forbackward transfer partitioning (backward extraction; BE) of a 4-MUpartitioning assay used to evaluate the effect of aqueous phasesurfactants on 4-MU containment. In this example, surfactants wereselected from an array of different surfactants available in thedetergent testing kit HR2-408 from Hampton Research, Inc. The experimentwas performed using 5 cSt silicone oil with 0.1% w/v Triton X-15 as theorganic phase (oil phase). Each surfactant was used at 1.5 times thesurfactant's critical micellar concentration (CMC). The identity of eachsurfactant is listed in Table 9. AS17 (ANAPOE®-20 or Tween® 20) was usedas a reference signal (43,000-44,000 RFU) and reflects an example of thelevel of droplet cross-contamination that may be observed in a newborntesting assay performed on a droplet actuator. The data is presented inorder of decreasing efficiency of the different surfactants in retaining4-MU in an aqueous phase droplet.

TABLE 9 Aqueous surfactants (AS) in 4-MU retention assay of FIG. 19 AS #Surfactant AS 93 FOS-Choline ®-8 AS 91 ZWITTERGENT ® 3-10 AS 1 BAM AS 90FOS-Choline ®-9 AS 70 n-Hexyl-β-D-glucopyranoside AS 69 CYMAL ®-2 AS 66MEGA-8 AS 68 HEGA ®-8 AS 89 n-Decyl-N,N-dimethylglycine AS 67 HEGA ®-9AS 88 FOS-Choline ®-10 AS 83 ZWITTERGENT ® 3-12 AS 7 Sodium cholate AS 9ANAPOE ®-X-305 AS 92 CYCLOFOS ™-3 AS 62 CYMAL ®-3 AS 86 CHAPS AS 94ZWITTERGENT ® 3-08 AS 77 NDSB-256 AS 80 FOS-Choline ®-12 AS 58 MEGA-9 AS87 CHAPSO AS 85 FOS-MEA ®-10 AS 78 ZWITTERGENT ® 3-14 AS 64 HEGA ®-9 AS63 C-HEGA ®-10 AS 84 DDMAB AS 81 FOS-Choline ®-8, fluorinated AS 95LysoFos ™ Choline 12 AS 2 n-Dodecyl-β-iminodipropionic acid, monosodiumsalt AS 79 n-Dodecyl-N,N-dimethylglycine AS 82n-Undecyl-N,N-Dimethlamine-oxide AS 60 n-Heptyl-β-D-thioglucopyranosideAS 25 ANAPOE ®-C₁₂E₁₀ AS 54 Pluronic ® F-68 AS 53 C-HEGA ®-11 AS 55HECAMEG ® AS 29 ANAPOE ®-X-405 AS 17 ANAPOE ®-20 (Tween ® 20) AS 56n-Octyl-β-D-glucoside AS 96 LysoFos ™ Choline 10 AS 592,6-Dimethyl-4-heptyl-β-D-malto-pyranoside AS 57 n-Octanoylsucrose AS 31ANAPOE ®-C₁₀E₆ AS 74 NDSB-201 AS 12 ANAPOE ®-58 AS 34 ANAPOE ®-C₁₀E₉ AS19 ANAPOE ®-35Modification of 4-MU and HMU Substrates for NBS

Droplet actuator-based lysosomal enzyme tests used in newborn testingassays (NBS) are fluorescent based tests which measure the release of4-methylumbelliferone (4-MU) or6-hexadecanoylamido-4-methylumbelliferone (HMU) after enzymatichydrolysis of the substrates. The enzymatic assays of the invention maybe performed in aqueous droplets within the oil filled gap of thedroplet actuator. In one example, the oil filler fluid may bepolydimethylsiloxane silicon oil (PDMS). The lysosomal enzyme tests areperformed at acidic pH values ranging between pH 2.8 and pH 5.6. In someembodiments after incubation, the enzymatic reactions may be terminatedby the addition of sodium bicarbonate, pH 10.1 which also dissociatesthe proton from the umbelliferone hydroxyl leading to a substantialincrease in fluorescent signal. At the acid pH values used for testinglysosomal enzymes, the products of the assays, 4-MU and HMU, areprotonated and may partition from the aqueous droplet into the PDMSfiller fluid. Partitioning of 4-MU and HMU into the oil phase may resultin a reduction in the assay signal and potential contamination ofneighboring samples.

The invention provides methods to substantially reduce or eliminate theoil solubility of umbelliferyl derivatives (e.g., 4-MU and HMU) duringfluorescent based assays (e.g., NBS samples, assays, glycosidase,protease, and immunoassays) on a droplet actuator. In one embodiment,chemical modification of 4-MU and HMU may be used to form derivativeswith substantially reduced solubility in the oil filler fluid (e.g.,PDMS). Examples of chemical modifications that may be used to reduce theoil solubility of umbelliferyl derivatives may include addition of aminogroups, carbon chain length, tethering 4-MU or HMU with molecules suchas cellulose or polylysine. Chemical modification(s) may be selectedsuch that activity and/or specificity of the enzymatic reaction (e.g.,various lysosomal enzyme assays) are not substantially altered(disrupted). Chemical modification(s) may also be selected such that thefluorescent signal of 4-MU or HMU is not eliminated. Preferably,retaining enough fluorescent signal of 4-MU or HMU to distinguish apositive or negative in the test. Chemical modification(s) may also beselected such that the umbelliferyl derivatives are compatible withdownstream synthetic reactions used to prepare individual assaysubstrates. Chemical modification(s) may also be selected such that theumbelliferyl derivatives have sufficient water solubility suitable forspecific NBS assays. In one example, the water solubility ofumbelliferyl derivatives may be selected for assay conditions rangingbetween pH 3.5 and pH 6.0. Suitable umbelliferyl derivatives may, forexample, be selected using the Log D values at pH 3.5 and pH 6.0.

In one example, the 4-methyl group of 4-MU and HMU may be modified witha chemical structure that increases the hydrophilicity of 4-MU and HMU.Because the 4-MU and HMU derivatives are hydrophilic, retention of thefluorescent derivatives in the aqueous phase reaction droplet issubstantially increased. Examples of suitable chemical structures thatmay be used to modify 4-MU and HMU to increase their hydrophilicityinclude, but are not limited to, polymers including linear or branchedpolyalkalene glycols (PAG), such as polyethylene glycols (PEG), and/orpolypropylene glycols (PPG), or combinations of PEG and PPG; sulfonicacids; and amino groups. The efficacy of chemical modification inpromoting retention of 4-MU and HMU in the aqueous phase may, forexample, be evaluated using an on-chip partitioning assay.

The compounds described herein are analogs of 4-methylumbilleferone(4-MU) and 6-hexadecanoyl-4-methylumbelliferone.

The 4-MU analogs have one of the following general formulas:

wherein:X is, independently, selected from the group consisting of O, S, and NH,R₁ is selected from the group consisting of H, C₁₋₁₅ oxyalkyl, —C₁₋₁₅aminoalkyl, —C₁₋₁₅ alkylamino, —(CH₂CH₂O)_(n)—CH₃, —(CH₂CH₂O)_(n)—SO₃H,C₁₋₆-alkyl-C(O)NH₂, —(CH₂CH₂NH)_(n)—H, —SO₃H, —C₁₋₆-alkyl-C(O)OH,—SO₃Me, C₁₋₆-alkyl-heterocyclyl, monosaccharides, and disaccharidesR₂ is H, a monosaccharide, a disaccharide, or a polyhydric alcohol;R₃ is a hydrophilic oligomer or polymer, which can be selected from thegroup consisting of polyalkylene glycols, such as polyethylene glycol,wherein the polyalkylene glycols can optionally further include NH or Smoieties; polycationic polymers such as polylysine; carbohydrates,including mono-saccharides and disaccharides, C₁₋₁₅ oxyalkyl, —C₁₋₁₅aminoalkyl, —C₁₋₁₅ alkylamino, —(CH₂CH₂O)_(n)—CH₃, —(CH₂CH₂O)_(n)—SO₃H,C₁₋₆-alkyl-C(O)NH₂, —(CH₂CH₂NH)_(n)—H, —SO₃H, —C₁₋₆-alkyl-C(O)OH,—SO₃Me, C₁₋₆-alkyl-heterocyclyl, monosaccharides, and disaccharides,and n is an integer of from 1 to 100, or from 1 to 50, or from 1 to 25,or from 1 to 10.

The hydrophilic polymer or oligomer can be any of a variety of oligomerscomprising a polyalkalene glycol moiety, as will be understood by thoseskilled in the art. Preferably, the polyalkalene glycol moiety of theoligomer has 1-100 polyalkalene glycol subunits. More preferably, thepolyalkalene glycol moiety has 1-50 polyalkalene glycol subunits and,most preferably, the polyalkalene glycol moiety has 1-25 polyalkaleneglycol subunits.

The hydrophilic polymer or oligomer can be any of a variety of oligomerscomprising a polyethylene glycol moiety, as will be understood by thoseskilled in the art. Preferably, the polyethylene glycol moiety of theoligomer has 1-100 polyethylene glycol subunits. More preferably, thepolyethylene glycol moiety has 1-50 polyethylene glycol subunits and,most preferably, the polyethylene glycol moiety has 1-25 polyethyleneglycol subunits.

The hydrophilic polymer or oligomer can be any of a variety of oligomerscomprising a polypropylene glycol moiety, as will be understood by thoseskilled in the art. Preferably, the polypropylene glycol moiety of theoligomer has 1-100 polypropylene glycol subunits. More preferably, thepolypropylene glycol moiety has 1-50 polypropylene glycol subunits and,most preferably, the polypropylene glycol moiety has 1-25 polypropyleneglycol subunits.

Additional hydrophilic oligomers and polymers include those containingpolar or charged functional groups, rendering them soluble in water. Forexample, acrylics include acrylic acid, acrylamide, and maleic anhydridepolymers and copolymers Amine-functional polymers include allylamine,ethyleneimine, oxazoline, and other polymers containing amine groups intheir main- or side-chains, such as polylysine. These may be combinedwith PAGs.

The oligomer may comprise one or more other moieties as will beunderstood by those skilled in the art including, but not limited to,additional hydrophilic moieties, lipophilic moieties, spacer moieties,linker moieties, and terminating moieties. The various moieties in theoligomer are covalently coupled to one another by either hydrolyzable ornon-hydrolyzable bonds.

The or more additional hydrophilic moieties (i.e., moieties in additionto the polyethylene glycol moiety) can include, but are not limited to,sugars, polyhydric alcohols, polyalkylene oxides, and polyamine/PEGcopolymers. As polyethylene glycol is a polyalkylene oxide, theadditional hydrophilic moiety may be a polyethylene glycol moiety.Adjacent polyethylene glycol moieties will be considered to be the samemoiety if they are coupled by an ether bond. For example, the moiety—O—C₂H₄—O—C₂H₄—O—C₂H₄—O—C₂H₄—O—C₂H₄—O—C₂H₄— is a single polyethyleneglycol moiety having six polyethylene glycol subunits. Adjacentpolyethylene glycol moieties will be considered to be different moietiesif they are coupled by a bond other than an ether bond.

The oligomer can further comprise one or more spacer moieties as will beunderstood by those skilled in the art. Spacer moieties are preferablyselected from the group consisting of sugar, cholesterol and glycerinemoieties.

The oligomer can further comprise one or more terminating moieties atthe one or more ends of the oligomer, which are not coupled to the 4-HUor 6HMU backbone. The terminating moiety is preferably an alkyl oralkoxy moiety, and is more preferably a lower alkyl or lower alkoxymoiety (where lower means C₁₋₆). Most preferably, the terminating moietyis methyl or methoxy. While the terminating moiety is preferably analkyl or alkoxy moiety, it is to be understood that the terminatingmoiety may be various moieties as will be understood by those skilled inthe art including, but not limited to, sugars, cholesterol, alcohols,and fatty acids. The oligomer or polymer may include one or more anionicor self-forming moieties, such as tertiary anion.

A subset of Formulas 1-5 is shown below, in which each R₂ is H.

wherein:R₁ is selected from the group consisting of H, C₁₋₁₅ oxyalkyl, —C₁₋₁₅aminoalkyl, —C₁₋₁₅ alkylamino, —(CH₂CH₂O)_(n)—CH₃, —(CH₂CH₂O)_(n)—SO₃H,C₁₋₆-alkyl-C(O)NH₂, —(CH₂CH₂NH)_(n)—H, —SO₃H, —C₁₋₆-alkyl-C(O)OH,—SO₃Me, C₁₋₆-alkyl-heterocyclyl, monosaccharides, and disaccharides.R₃ is a linear or branched hydrophilic oligomer or polymer, which can beselected from the group consisting of polyalkylene glycols, such aspolyethylene glycol, wherein the polyalkylene glycols can optionallyfurther include NH or S moieties; polycationic polymers such aspolylysine; carbohydrates, including mono-saccharides and disaccharides,C₁₋₁₅ oxyalkyl, —C₁₋₁₅ aminoalkyl, —C₁₋₁₅ alkylamino,—(CH₂CH₂O)_(n)—CH₃, —(CH₂CH₂O)_(n)—SO₃H, C₁₋₆-alkyl-C(O)NH₂,—(CH₂CH₂NH)_(n)—H, —SO₃H, —C₁₋₆-alkyl-C(O)OH, —SO₃Me,C₁₋₆-alkyl-heterocyclyl, monosaccharides, and disaccharides.X is, independently, selected from the group consisting of O, S, and NH,andn is an integer of from 1 to 100, or 1 to 50, or 1 to 25, or 1 to 10.

Representative sugar moieties that can be coupled to the 4-MU corestructure at position R₂ include, but are not limited to:

The sugar moieties shown are a-pyranose, b-pyranose, a-furanose, andb-furanose forms of allose, altrose, glucose, mannose, gulose, idose,galactose and talose, respectively. The sugar moeities can be attachedto the phenol moiety to form an ether linkage using etherificationtechniques, ideally those in which the hydroxy groups not involved inthe coupling chemistry are protected during the etherification step, anddeprotected at a later time in the overall synthesis. Suitableprotecting groups are described, for example, in Greene and Wuts,Protective Groups in Organic Synthesis, 3^(rd) Ed., John Wiley &Sons,1999, the contents of which are hereby incorporated by reference.

Where glucose is the sugar, and reacts with the phenol at R₂, theresulting compound is known as a glucopyranoside. For formation ofglucopyranosides is well known to those of skill in the art.

Ribose and deoxyribose sugars can also be coupled to the phenol atposition R₂:

Representative polyhydric alcohols include glycol (2-carbon), glycerol(3-carbon), erythritol (4-carbon), threitol (4-carbon), arabitol(5-carbon), xylitol (5-carbon), ribitol (5-carbon), mannitol (6-carbon),sorbitol (6-carbon), dulcitol (6-carbon), iditol (6-carbon), isomalt(12-carbon), maltitol (12-carbon), lactitol (12-carbon), andpolyglycitol.

Examples of individual 4-MU analogs include the following:

versions thereof in which one or more amines is quaternized to yield aquaternary ammonium salt, and salts thereof.

Examples of individual 4-HMU analogs that may be used in the methods forconducting enzymatic assays as described herein may include thestructures as shown in FIGS. 35A-H.

The compounds of Formula 1 can be prepared according to the followinggeneral synthetic strategies:

Starting from 4-methylcoumarin-3-acetic acid, succinimidyl ester(AnaSpec, Catalog No. 81239):

Reaction with a suitable amine-containing moiety (R₃—NH₂) displaces thesuccinimidyl (NHS) ester and forms an amide linkage:

NHS-ester crosslinking reactions are most commonly performed inphosphate, bicarbonate/carbonate, HEPES or borate buffers at pH 7.2-8.5for 0.5-4 hours at room temperature or 4° C. Primary amine buffers suchas Tris (TBS) are not compatible because they compete for reaction;however, in some procedures, it is useful to add Tris or glycine bufferat the end of a conjugation procedure to quench (stop) the reaction.

To prepare compounds in which a thioamide or C(NH)—NHR₃ moiety ispresent, one can start with an analog in which the carbonyl in thesuccinimidyl ester is replaced with a C(S) or a C(NH) moiety.

To prepare compounds of Formula 2, one can use the following reactions:

In these reactions, the phenol, if present at position R₂, should beprotected until after the coupling chemistry is completed.

Suitable C₁₋₁₅ oxyalkyl, —C₁₋₁₅ aminoalkyl, —C₁₋₁₅ alkylamino,—(CH₂CH₂O)_(n)—CH₃, —(CH₂CH₂O)_(n)—SO₃H, C₁₋₆-alkyl-C(O)NH₂,—(CH₂CH₂NH)_(n)—H, —SO₃H, —C₁₋₆-alkyl-C(O)OH, —SO₃Me,C₁₋₆-alkyl-heterocyclyl, monosaccharides, disaccharides, and othermoieties are well known to those of skill in the art, and can readily beprepared.

In the case of ester formation, one can reflux the desired alcohol withthe carboxylic acid (where X is O) moiety and, using a Dean-Stark trap,remove water as it is formed to drive the equilibrium towards products.

To prepare compounds of Formula 3, one can use the following reactions:

where the carbon on R₁ bonded to the halogen (preferably Cl, Br, or I),or, alternatively, another suitable leaving group, is a primary orsecondary carbon.

In these reactions, the phenol, if present at position R₂, should beprotected until after the coupling chemistry is completed.

where X is an alkoxy or thioalkoxy moiety. When X is an amine, the aminecan be used to displace the leaving group, without needing todeprotonate the amine (i.e., without needing to form R₁—NH⁻).

To prepare compounds of Formula 4, one can use the following reaction:

where X is an alkoxy or thioalkoxy moiety. When X is an amine, the aminecan be used to displace the leaving group, without needing todeprotonate the amine (i.e., without needing to form R₁—NH⁻).

Alternatively, the chemistry can be performed in a stepwise manner,where a moiety HX—CH₂—C(O)—XH is deprotonated, and the more basic X⁻anion (i.e., the one attached to the CH₂ moiety rather than the C(O)moiety) acts as a nucleophile to displace the leaving group. Then, theless basic X⁻ anion can be protonated, and converted to a suitableleaving group (i.e., an acid halide, an anhydride, and the like), and anR₁XH moiety reacted with the leaving group to form the final product.

In these reactions, the phenol, if present at position R₂, should beprotected until after the coupling chemistry is completed.

To prepare compounds of Formula 4, one can use the following reaction:

In this reaction, the phenol, if present at position R₂, should beprotected until after the coupling chemistry is completed. Similarly,any functional groups on R₁ that would otherwise react with theisocyanate should be protected.

Examples of the 6-HMU analogs have the following general formulas:

wherein:X is, independently, selected from the group consisting of O, S, and NH,R₁ is selected from the group consisting of H, C₁₋₁₅ oxyalkyl, —C₁₋₁₅aminoalkyl, —C₁₋₁₅ alkylamino, —(CH₂CH₂O)_(n)—CH₃, —(CH₂CH₂O)_(n)—SO₃H,C₁₋₆-alkyl-C(O)NH₂, —(CH₂CH₂NH)_(n)—H, —SO₃H, —C₁₋₆-alkyl-C(O)OH,—SO₃Me, C₁₋₆-alkyl-heterocyclyl, monosaccharides, and disaccharides.R₂ is H, a monosaccharide, a disaccharide, or a polyhydric alcohol;R₃ is a hydrophilic oligomer or polymer, which can be selected from thegroup consisting of polyalkylene glycols, such as polyethylene glycol,wherein the polyalkylene glycols can optionally further include NH or Smoieties; polycationic polymers such as polylysine; carbohydrates,including mono-saccharides and disaccharides, C₁₋₁₅ oxyalkyl, —C₁₋₁₅aminoalkyl, —C₁₋₁₅ alkylamino, —(CH₂CH₂O)_(n)—CH₃, —(CH₂CH₂O)_(n)—SO₃H,C₁₋₆-alkyl-C(O)NH₂, —(CH₂CH₂NH)_(n)—H, —SO₃H, —C₁₋₆-alkyl-C(O)OH,—SO₃Me, C₁₋₆-alkyl-heterocyclyl, monosaccharides, and disaccharides.R₄ is a C₅₋₁₆ alkyl, oxyalkyl, or amino-oxyalkyl, moiety, andn is an integer of from 1 to 100, or 1 to 50, or 1 to 25, or 1 to 10 andVersions thereof in which one or more amines is quaternized to yield aquaternary ammonium salt, and salts thereof.

Examples of individual 6-HMU analogs include the following:

Examples of individual 6-HMU analogs may further include the structuresas shown in FIGS. 36 A-H.

The compounds of Formulas 6-10 can be prepared using the same generalreactions used to prepare the compounds of Formulas 1-5, except that thestarting materials further include a —NH—C(X)—R₄ moiety. The amide,thioamide, or —C(NH)—NH— moiety is non-reactive under the couplingconditions used to prepare the compounds, so can be present at the timethe coupling chemistry is performed. Alternatively, a protected anilinemoiety (next to the phenol moiety) can be present, and can bedeprotected at an appropriate time after the coupling chemistry iscomplete. From there, the aniline group can be reacted with a suitableacid chloride (i.e., R₄—C(O)-halo), or acid anhydride(R₄—C(O)—O—C(O)—R₄) to form an amine.

Enhanced Hydrolysis of Enzymatic Substrates

Fluorescent substrates used in enzymatic NBS assays may have varyingdegrees of hydrophobicity. Because the fluorescent substrates may behydrophobic, their interaction with more hydrophilic enzymes, such asthe enzymes in dried blood extracts, may be reduced. The inventionprovides methods to enhance the hydrolysis of enzymatic substrates suchas fluorescent substrates used in NBS assays. In one embodiment, thehydrolysis of enzymatic substrates (e.g., 4-MU- or HMU-containingsubstrates) may be enhanced by formation of an inclusion complex thatstabilizes the substrate within an aqueous environment. For example,cyclodextrins (e.g., hydroxypropyl-β-cyclodextrin,methyl-β-cyclodextrin) may be used to form an inclusion complexcontaining a hydrophobic substrate. Negatively charged cyclodextrins,may be used to further enhance substrate hydrolysis. The methods of theinvention provide for improved separation between a lower signal and ahigher signal in enzyme-substrate based bioassay such as NBS assays forFabry, Gaucher, Pompe, Krabbe, and Niemann-Pick diseases.

To evaluate the efficacy of cyclodextrins in enhancing the hydrolysis ofenzymatic substrates (4-MU substrates) used in NBS assays, DBS extractswere prepared from quality control (QC) dried blood spot samples (i.e.,base pool (BP), low (L), medium (M) and high (H) activity samples). TheQC samples were obtained from CDC, Atlanta Ga. The base pool (BP) QCsample was prepared from a pool of leukoreduced human red blood cellsthat was adjusted with serum to a hematocrit of 50%. The High (H)activity QC sample was prepared from pooled cord blood that was adjustedwith serum to a hematocrit of 50%. The medium (M) activity QC sample wasprepared by using 50% base pool (BP) and 50% high (H) activity sample.The low (L) activity QC sample was prepared by using 95% base pool (BP)and 5% high (H) activity sample. The BP sample is used as a control forhydrolysis non-specific to white blood cell lysosomal enzymes. The DBSextracts were analyzed using on-bench assay protocols for Fabry,Gaucher, Krabbe, and Pompe diseases. For each assay, on-chip reagentformulations were scaled up to bench volumes.Hydroxypropyl-β-cyclodextrin or methyl-β-cyclodextrin reagent stocks(300 mM) were prepared in appropriate assay buffers. For each reaction,10 μL of the appropriate substrate was mixed with 10 μL of DBS extract.After an incubation period (20 hrs at 37° C.), 50 μL of stop buffer (0.2M NaCO₃, pH 10.1) was added to the reaction. Fluorescence was read at360/460 nm at a gain of 75. For each assay, QC samples (BP, L, M and H)were analyzed in duplicate.

FIGS. 20A and 20B show bar graphs 2000 and 2050 of the effect ofhydroxypropyl-β-cyclodextrin and methyl-β-cyclodextrin, respectively, onsubstrate hydrolysis in a Fabry assay. The 4-MU substrate in the Fabryassay was β-D-galactopyranoside. The concentrations of β-cyclodextrinsin the reaction mixture (substrate+DBS extract) were 10 mM, 30 mM and100 mM. The data show that low concentrations (10 mM) ofmethyl-β-cyclodextrin increase the hydrolysis of the 4-MU substrate inthe Fabry assay and improve the separation between low, medium and highQC-dried blood spot samples. The effect of hydroxypropyl-β-cyclodextrinwas less effective.

FIGS. 21A and 21B show bar graphs 2100 and 2150 of the effect ofhydroxypropyl-β-cyclodextrin and methyl-β-cyclodextrin, respectively, onsubstrate hydrolysis in a Gaucher assay. The 4-MU substrate in theGaucher assay was β-D-glucopyranoside. The concentrations ofβ-cyclodextrins in the reaction mixture (substrate+DBS extract) were 10mM, 30 mM, and 100 mM. The data show that low concentrations (10 mM) ofhydroxypropyl- and methyl-β-cyclodextrin increase the hydrolysis of the4-MU substrate in the Gaucher assay and improve the separation betweenlow, medium and high QC-dried blood spot samples.

To further evaluate the efficacy of lower concentrations ofcyclodextrins in enhancing the hydrolysis of 4-MU substrates, Fabry andGaucher assays were repeated using cyclodextrins concentrations rangingfrom 1 mM to 25 mM. FIGS. 22A and 22B show bar graphs 2200 and 2250,respectively, of the effect of lower concentrations ofhydroxypropyl-β-cyclodextrin and methyl-β-cyclodextrin, respectively, onsubstrate hydrolysis in a Fabry assay. The 4-MU substrate in the Fabryassay was β-D-galactopyranoside. The concentrations of β-cyclodextrinsin the reaction mixture (substrate+DBS extract) were 1, 5, 10, 15, 20,and 25 mM. The data show that methyl-β-cyclodextrin (10 mM) has apositive effect on the Fabry assay increasing the QC-H signal by 37%.The preferred concentration of methyl-β-cyclodextrin is from about 1 mMto about 20 mM, or from about 5 mM to about 15 mM, or from about 7 mM toabout 13 mM, or from about 9 mM to about 11 mM, or from about 9.5 mM toabout 11.5 mM. The effect of hydroxypropyl-β-cyclodextrin on substratehydrolysis in a Fabry assay was less effective.

FIGS. 23A and 23B show bar graphs 2300 and 2350, respectively, of anexperimental result of the effect of lower concentrations ofhydroxypropyl-β-cyclodextrin and methyl-β-cyclodextrin, respectively, onsubstrate hydrolysis in a Gaucher assay. The 4-MU substrate in theGaucher assay was β-D-glucopyranoside. The concentrations ofβ-cyclodextrins in the reaction mixture (substrate+DBS extract) were 1,5, 10, 15, 20, and 25 mM. The data in one experiment suggested that bothhydroxypropyl-β- and methyl-β-cyclodextrin may affect the fluorescencesignal (in at least one case showing an increase), in the Gaucher assay.The β-cyclodextrin used may be hydroxypropyl-β-cyclodextrin at aconcentration from about 5 mM to about 15 mM, or from about 7 mM toabout 13 mM, or from about 9 mM to about 11 mM, or from about 9.5 mM toabout 11.5 mM.

The effect of hydroxypropyl-β-cyclodextrin and methyl-β-cyclodextrin onsubstrate hydrolysis in a Pompe assay was less effective (data notshown). The effect of hydroxypropyl-β-cyclodextrin andmethyl-β-cyclodextrin on substrate hydrolysis in a Krabbe assay wasinhibitory (data not shown).

Clotting in Fabry Assay

The buffer system used to prepare substrate-inhibitor formulation forFabry disease may include 0.1M sodium citrate, a pH from about 4-5, orfrom about 4.2-4.8, or from about 4.5-4.7, or about 4.6, containing 1%sodium taurocholate. Although this formulation produces statisticallysignificant separation between the normal and Fabry affected dried bloodspot extracts, the inventors have found that it results in clotformation within the droplets. This clotting may adversely affect thereproducibility of the assay because enzyme may be trapped within theclots where it is unavailable to the substrate. The clots seemed toappear very early in the assay (30 minutes from the inception). Theinventors have found that a buffer system using 0.04M Sodium Citrate, apH from about 4-5, or from about 4.2-4.8, or from about 4.5-4.7, orabout 4.6, with 0.01% Tween® 20 does not affect the signal at all, andthe clot formation was eliminated. In another example, 0.04M SodiumAcetate, pH 4.6 with 0.01% Tween® 20 was used in preparingsubstrate-inhibitor formulation which produced the same results as theSodium citrate buffer. Thus, in one embodiment, the invention providesan enzymatic assay making use of blood, a blood component, or areconstituted blood spot, and further makes use of a substrate inhibitorformulation at a pH from about 4-5, or from about 4.2-4.8, or from about4.5-4.7, or about 4.6, but which lacks sodium taurocholate. In anotherembodiment, the invention provides an enzymatic assay making use ofblood, a blood component, or a reconstituted blood spot, and furthermakes use of a substrate inhibitor formulation at a pH from about 4-5,or from about 4.2-4.8, or from about 4.5-4.7, or about 4.6, andcomprises sodium citrate. In another embodiment, the invention providesan enzymatic assay making use of blood, a blood component, or areconstituted blood spot, and further makes use of a substrate inhibitorformulation at a pH from about 4-5, or from about 4.2-4.8, or from about4.5-4.7, or about 4.6, and comprises sodium acetate. In anotherembodiment, the invention provides an enzymatic assay making use ofblood, a blood component, or a reconstituted blood spot, and furthermakes use of a substrate inhibitor formulation at a pH from about 4-5,or from about 4.2-4.8, or from about 4.5-4.7, or about 4.6, andcomprises sodium citrate and lacks sodium acetate. In anotherembodiment, the invention provides an enzymatic assay making use ofblood, a blood component, or a reconstituted blood spot, and furthermakes use of a substrate inhibitor formulation at a pH from about 4-5,or from about 4.2-4.8, or from about 4.5-4.7, or about 4.6, andcomprises sodium acetate and lacks sodium acetate. In anotherembodiment, the invention provides an enzymatic assay making use ofblood, a blood component, or a reconstituted blood spot, and furthermakes use of a substrate inhibitor formulation at a pH from about 4-5,or from about 4.2-4.8, or from about 4.5-4.7, or about 4.6, andcomprises sodium citrate and a surfactant. In another embodiment, theinvention provides an enzymatic assay making use of blood, a bloodcomponent, or a reconstituted blood spot, and further makes use of asubstrate inhibitor formulation a pH from about 4-5, or from about4.2-4.8, or from about 4.5-4.7, or about 4.6, and comprises sodiumacetate and a surfactant.

Alternative Assay Protocols

In one embodiment, an assay in accordance with the invention involvesthe following: One set of dried blood spot extract droplets is combinedusing droplet operations with one set of substrate fluid droplets. Theresulting set of 2× droplets is split using droplet operations to formtwo sets of 1× droplets. Each droplet in the first set of 1× droplets iscombined using droplet operations with a stop buffer droplet. Endpointfluorescence of the combined droplet measured. The second set of 1×reaction droplets is incubated for a predetermined time and then eachreaction droplet is combined with a stop buffer droplet. Again, endpointfluorescence is measured. The difference between time t−END hrs and t−0hrs is reported. However, in some protocols there is no time t−0measurement, which reduces the number of droplet handling operations byhalf.

In one embodiment, a droplet actuator of the invention is configured toperform 5-plex assays on 48 samples (240 assays) which means 240 2×droplets have to be stored for 20 hours in the limited real estate onthe chip. Since 2× droplets cannot be stored on a 3 phase bus, the 2×droplets may be split using droplet operations, and 1× may betransported to waste while the remaining 1× droplet is incubated. In oneembodiment, all the dispensing electrodes (reagent and sample) aresmaller than the electrodes on the rest of the chip (900 microns or 750microns; gap height 285 microns). In such a droplet actuator, a 2×droplet on the smaller electrodes would actually be close to a 1×droplet on the larger electrodes. This configuration would avoid theneed for splitting the droplet, and would simplify droplet actuatordesign and work flow easier.

As already noted, a disadvantage performing detection at time t=0 andt=20 hours is the number of droplets that should be handled. Performing“m” plex assays on “n” number of samples, requires the total number ofdroplets to be “m*n*2”, which limits the total number of samples thatcan be screened on a single droplet actuator. To fit as many samples aspossible on a single cartridge, it is helpful to avoid the time t=0measurement. The main reasons to perform a time t=0 measurement are toassess the quality of the substrates; to determine non-enzymatichydrolysis; and to account for the effect of hemoglobin quench offluorescence.

However, as already discussed, the inventors have surprisingly foundthat DBS quench on fluorescence is very minimal on chip due to the lowpath lengths. So it can safely be assumed that that hemoglobin does notaffect fluorescence. By detecting the background fluorescence of all thesubstrates before the start of the actual assay, the QC of all thesubstrates can be obtained. A blank extract may be incubated with thesubstrate as a control for non-enzymatic hydrolysis. By taking thesesteps, the time t=0 measurement can be eliminated, thereby reducing thetotal number of droplets to handle by half. A droplet of knownconcentration of 4-MU sodium salt may be dispensed using dropletoperations and its fluorescence may be detected to provide a calibrant.One droplet each of substrate may be dispensed and merged using dropletoperations with a droplet of stop buffer. Endpoint fluorescence of thiscombination may be detected to assess the QC of the substrates andprovide time t=0 measurement. Next, one droplet of each substrate may bemerged with a corresponding droplet of DBS extract, yielding a set ofreaction droplets. At the end of the incubation period, the reactiondroplet may be combined with a stop buffer droplet, and endpointfluorescence may be detected.

Hemoglobin Quench Normalization for NBS Assays

Dried blood spots (DBS) from newborns for testing of lysosomal storagedisease (LSD) enzymes are inherently variable because of the variationin hematocrit between individuals and the irregular deposition of theblood across the filter paper. This variation leads to differences inthe amount of hemoglobin in the final assay for a LSD target enzyme. Insome cases, hemoglobin (or other quenching material) in the DBS samplemay quench the fluorescence emitted from the reaction product (e.g.,4-MU or HMU). In the event of hemoglobin quench on fluorescence, enzymeactivity in a sample may be underestimated.

The invention provides assay methods to measure fluorescence (e.g. 4-MUor HMU) quench in a reconstituted DBS sample in a droplet actuator-basedNBS assay. In one example of a droplet actuator-based NBS assay, adroplet of known concentration of 4-MU (4-MU standard droplet) iscombined using droplet operations with a droplet of reaction terminationbuffer (stop buffer) and fluorescence detected on-chip to provide acalibration value for the enzyme assays. This same 4-MU standard dropletmay also be used to determine a quench coefficient for each DBS sampledroplet to be tested. An example of an assay format for measuringfluorescence quench in a reconstituted DBS sample includes, but is notlimited to, the following steps: At the start of an assay, a DBS sampledroplet is dispensed and combined using droplet operations with adroplet of the 4-MU standard in termination buffer and the fluorescenceread (no incubation period required). If no hemoglobin or quenchingmaterial is present in the DBS sample droplet, the fluorescence of thecombined DBS sample/4-MU droplet will be equivalent to the fluorescenceof the 4-MU standard droplet. The quench coefficient will be 1.0 or noquench observed. If hemoglobin or quenching material is present in theDBS sample droplet, a lower fluorescent signal will be detected in thecombined DBS sample/4-MU droplet relative to the fluorescence of the4-MU standard droplet. The fluorescence of the combined DBS sample/4-MUdroplet divided by the fluorescence of the 4-MU standard droplet is ameasure of the fluorescence quench (quench coefficient) in the sample.The fluorescence quench coefficient for each sample may be used tonormalize all of the fluorescent output signals from all of the DBSassay samples and eliminate the differences in signal outputs because ofdifferences in hemoglobin content (or other quench material) in eachsample.

Multiplexed Pompe, Fabry and Hunter's Assays on a Droplet Actuator

The invention provides a droplet actuator device and methods formultiplexed testing (3-plex assay on 12 samples) for Pompe, Fabry andHunter's lysosomal storage disorders (LSDs) on a single dropletactuator. In one embodiment, samples used for multiplexed testing forLSDs may be prepared from dried blood spots (DBS) using an on-benchprotocol prior to loading on a droplet actuator. Reagent preparation(e.g., stop buffer, extraction buffer, substrate formulations andcalibrant) may also be prepared using on-bench protocols prior toloading on a droplet actuator. In another embodiment reagent and/orsamples may be prepared in reservoirs on the droplet actuator thenflowed to different operations gaps, or prepared in the dropletoperations gap.

Substrate Formulations and Reagent Preparation

All reagents and formulations required for Pompe, Fabry and Hunter'sassays may be prepared on-bench and subsequently loaded into fluiddispensing reservoirs of a droplet actuator. Reagents common to allthree assays include: stop buffer (STB; 0.2M Sodium bicarbonate pH 10.0with 0.01% Tween® 20) and calibrant (CAL; 0.15 μM 4-Methyl umbelliferoneprepared in stop buffer) used to calibrate fluorescence detection.Specific substrate formulations for Pompe, Fabry and Hunter's assays aresummarized in Table 10. In another embodiment reagent and/or samples maybe prepared in reservoirs on the droplet actuator then flowed todifferent operations gaps, or prepared in the droplet operations gap.

TABLE 10 Summary of substrate formulations Inhibitor or Substrate TotalAssay Buffer (μL) Enzyme (μL) (μL) volume(μL) PI-DIL  197 (PB) 3 (PI)N/A 200 POM 41.4 (PB) 5.0 (PI-DIL) 3.6 (PS) 50.0 FAB 39.3 (FB) 10.0 (FI)0.7 (FS) 50.0 HUN N/A 2.0 (HE) 18.0 (HS)  20.0

Reagents to prepare stock solutions and buffers for testing forlysosomal storage disorders (LSDs), such as Pompe, Fabry, Gaucher,Hurler and Hunter assays on a droplet actuator may include any one ormore of the following: Fabry substrate (FS), e.g., 4-Methylumbelliferylα-D-Galactopyranoside (4-MU-α Gal); Fabry inhibitor (FI), e.g.,N-Acetyl-D-Galactosamine (GalNaC); Sodium Acetate (99% purity); AceticAcid, 99.5% (17.4N); Pompe substrate (PS), e.g.,4-MU-α-D-glucopyranoside (4-MU-α-Gluc); Pompe Inhibitor (PI), e.g.,Acarbose; Hunter Substrate (HS), e.g.,4-Methylumbelliferyl-α-L-Iduronide-2-Sulphate (4 MU-αIdoA-2S); Lead (II)Acetate Trihydrate, reagent grade; Molecular biology grade BSA;Recombinant Iduronidase from R&D Systems (HE), e.g., Recombinantα-L-Iduronidase supplied at 0.5 mg/mL (20 μL) in 0.05M Sodium Acetate pH5.0 with 0.5M NaCl; Gaucher Substrate (GS), e.g., 4-Methyumbelliferylβ-D-Glucopyranoside (4-MU-β-Gluc); Hurler Substrate (MS), e.g.,4-Methylumbelliferyl-α-LIduronide Sodium Salt (4-MU-α-Idu); HurlerInhibitor (MI), e.g., D-Saccharic acid 1,4-lactone monohydrate (D-Sac);Methyl-β-Cyclodextrin (MBCD); Dimethyl sulphoxide (DMSO); Moleculargrade water; Tween® 20; Sodium bicarbonate; 4-Methyl UmbelliferoneSodium salt; Sodium chloride (NaCl), Molecular Biology Grade; SodiumPhosphate, monohydrate; Citric Acid, monohydrate; Taurocholic acid,sodium salt; Sodium Hydroxide (NaOH); Polydimethlysiloxane,Trimethlysiloxy Terminated (OIL); and Triton™ X15.

Stock solutions of Pompe substrate (PS; 70 mM 4-MU-α-D-glucopyranoside(4-MU gluc) in DMSO) and Pompe inhibitor (PI; 8 mM Acarbose prepared in0.04 M Sodium Acetate, pH 3.8) may be prepared, aliquoted and stored at−80° C. until use.

Preparation of the substrate formulation for the Pompe assay includesthe following steps:

-   -   1. Remove aliquots of PS and PI from the freezer and thaw at        room temperature for 5 min in the dark (e.g., covered with        aluminum foil);    -   2. Prepare a working stock of PI-DIL (120 μM Acarbose in 0.04 M        Sodium Acetate, pH 3.8) by adding 3 μL of PI (8 mM Acarbose        stock) to 197 μL of Pompe assay buffer (PB; 0.04 M Sodium        Acetate, pH 3.8); and    -   3. Add 41.4 μL of PB (0.04 M Sodium Acetate pH 3.8), 5 μL of        PI-DIL (120 μM Acarbose solution) and 3.6 μL of PS (70 mM        substrate stock) in that order to yield 50 μL of reagent        formulation. Vortex thoroughly. The final substrate        concentration in the reagent formulation is 5 mM. The final        Acarbose (inhibitor) concentration in the reagent formulation is        12 μM.

In an embodiment a method of preparing a stock solution of about 1800 μLPompe substrate (PS), with a molecular weight of about 4-MU-α-Gluc-338.3 g/mol, at a concentration of about 70 mM), may include thefollowing protocol. Weigh about 43 mg of 4-MU-α-Gluc and dissolve inabout 1800 μL of DMSO; and vortex thoroughly until the substratecompletely dissolves in the solution.

In an embodiment a method of preparing about 7.2 mLs Pompe Inhibitor(PI) with a molecular weight of Acarbose of about 645.6 g/mol, with aconcentration of about 8 mM, may include the following protocol. Weighabout 37 mgs of Acarbose and dissolve in about 7.2 mL of 0.04M sodiumacetate pH 3.8; vortex thoroughly until it dissolves substantiallycompletely in the solution; and aliquote.

In an embodiment a method of preparing Pompe Buffer with about 21.5 mMMethyl-β-Cyclodextrin (PB) may include the following steps. Weigh about0.656 g of Sodium Acetate and dissolve in about 200 mL of moleculargrade water to result in about 0.04 M sodium acetate; vortex thoroughlyuntil it is substantially completely dissolved; adjust the pH bytitrating it with about 0.04M Acetic acid, measure the final pH using apH meter until the final pH of the solution is about 3.8; place about200 mL of the titrated buffer solution into about a 250-ml plasticbottle, add about 200 μL of 10% Tween® 20, cap and swirl for about 1minute; in about a 250-mL plastic bottle, weigh about 2.537 g (+/−2%) ofMethyl-β-Cyclodextrin; add about 90 mL of the buffer (0.04M Acetic acidpH 3.8, 0.01% Tween® 20); cap and swirl (if plastic bottle) or vortex(if centrifuge tube) until substantially complete dissolution of thesolid is achieved; dispense appropriate aliquots in centrifuge tubes;and store at about 4° C.

Stock solutions of Fabry substrate (FS; 4-Methyumbelliferylα-D-Galactopyranoside (4-MUGal)) and Fabry inhibitor (FI; 750 μM ofN-Acetyl-D-Galactosamine (GalNaC)) may be prepared in molecular gradewater, aliquoted and stored at −80° C. until use.

Preparation of the substrate formulation for the Fabry assay includesthe following steps:

-   -   1. Remove aliquots of FS and FI from the freezer and thaw at        room temperature for 5 min in the dark (e.g., covered with        aluminum foil); and    -   2. Add 39.3 μL of Fabry buffer (FB; 0.04M Sodium Acetate pH 4.6        with 0.01% Tween® 20), 10 μL of FI (750 μM N-Acetyl        Galactosamine) and 0.7 μL of FS (700 mM substrate stock) in that        order to obtain 50 μL of reagent formulation. Vortex thoroughly.        The final substrate concentration in the reagent formulation is        10 mM. The final inhibitor concentration in the reagent        formulation is 150 μM.

In an embodiment a method of preparing a stock solution of about 1080 μLFabry substrate (FS) of a molecular weight of 4-MU-α-Gal-338.3 g/mol, ata concentration of 0.7 mol/L (700 mM), with an aliquot size of about 3μL (each aliquot enough for about 4 cartridges including some overage),may include the following protocol. Weighing 256 mg of 4-MU-α-Gal anddissolve in 1080 μL of DMSO; vortex thoroughly until the substrate iscompletely dissolved in the solution; and aliquote.

In an embodiment a method of preparing about 18 mLs of Fabry Inhibitor(FI) of a molecular weight of about GalNac 221.21 g/mol, with aconcentration of about 750 μM, and an aliquot size of about 50 μL, mayinclude the following protocol. Weighing about 10 mg of GalNac anddissolve in about 60.24 mL of molecular grade water; Vortex thoroughlyuntil it is substantially completely dissolved in solution to obtainabout 750 μM concentrated GalNac solution; aliquote; and store at about−80° C.

In an embodiment a method of preparing Tween® 20, 10% w/v (10% Tween20),may include the steps of weighing 1 g of Tween® 20 into about a 15-mlcentrifuge tube; use molecular biology grade water and bring the volumeup to 10 mL; and vortex (5×10 s).

In an embodiment a method of preparing a Fabry buffer with about 25.5 mMMethyl-β-Cyclodextrin (FB), may include the steps of: weighing about0.656 g of sodium acetate and dissolve in about 200 mL of moleculargrade water; vortex thoroughly until completely dissolved; prepare about0.04 M acetic acid by measuring out about 0.46 mL about 17.4N aceticacid, then use molecular biology grade water and bring the solution to afinal volume of about 200 mL; adjust the pH by titrating it with about0.04 M Acetic acid; measure the final pH using a pH meter until thefinal pH of the solution is about 4.6; place about 200 mL of thetitrated buffer solution into about a 250-ml plastic bottle; add about200 μL of 10% Tween® 20; cap and swirl for about 1 minute; in about a50-mL centrifuge tube, weigh 1.10+/−0.02 g (+/−2%) ofMethyl-β-Cyclodextrin; add about 33.0 mL of the buffer; cap and swirl(if plastic bottle) or vortex (if centrifuge tube) until substantiallycomplete dissolution of the solid is achieved; aliquote; and store atabout 4° C.

Stock solutions of Hunter substrate (HS; 1.25 mM4-Methylumbelliferyl-α-L-Iduronide-2-Sulfate prepared in 0.1 M SodiumAcetate pH 5.0 containing 10 mM Lead Acetate; 0.01% Tween® 20) andRecombinant Iduronidase (HE; 10 μg/mL of Iduronidase in Hunter assaybuffer (HB; 0.05 M Sodium Acetate pH 5.0 with 0.01% Tween® 20 and 1mg/mL BSA)) may be prepared, aliquoted (10 μL) and stored at −80° C.until use.

Preparation of the substrate formulation for the Hunter assay includesthe following steps:

-   -   1. Remove aliquots of HS and HE from the freezer and thaw at        room temperature for 5 minutes in the dark (e.g., covered with        aluminum foil); and    -   2. Add 2 μL of HE (10 μg/mL Iduronidase) to 18 μL of HS (1.25 mM        4-MU-α-L-Iduronide-2-Sulfate). The final substrate concentration        in the reagent formulation is 1.125 mM. The final Iduronidase        concentration in the reagent formulation is 1.0 μg/mL.

In an embodiment a method of preparing 1 L of Hunter Substrate bufferwith Methyl-β-Cyclodextrin (HSB) (0.1M Sodium Acetate/0.1M Acetic acidbuffer containing 10 mM lead acetate, 0.01% Tween® 20, 22.2 mM Me-b-CD),may include the following. Tare a 2-L beaker containing about a 3″stirbar; weigh about 800 g of molecular biology grade water (max=about994.25 g) into the beaker, and add about 5.75 mL of acetic acid (17.4 N)measured with a serological plastic pipette; stir for about 10 min witha magnetic stirrer at medium speed; bring the final volume to about 1 Lwith molecular biology grade water, this makes about 0.1M acetic acid.Then weigh about 8.2 g of sodium acetate in a weighing boat, and add thesolid quantitatively to the beaker, (i.e. rinsing the boat out severaltimes with molecular biology grade water and adding the rinses to thebeaker); stir until all solids are substantially dissolved (˜10minutes); bring the final volume up to about 1 L with molecular biologygrade water, this makes about 0.1M sodium acetate. Next weigh 0.285 g oflead II acetate (Pb(OAc)₂.3H₂O) into a weighing boat, and transferquantitatively into a 250-ml plastic bottle fitted with about a 1″-1.5″magnetic stir bar; Add about 75 mL of the plain 0.1 M Sodium acetatebuffer (pH about 5.0) to the bottle; Add about 75 uL of 10% Tween® 20 tothe same bottle; Stir magnetically for about 10 min while avoiding theformation of excessive foam; In a about 50-mL centrifuge tube, weighabout 0.655 g (+/−2%) of Methyl-β-Cyclodextrin required for the totalHSB preparation (prep is available in multiples of about 8.33 mL); Addabout 22.5 mL of the buffer solution; cap and vortex until substantiallycomplete dissolution of the solid is achieved; and store at 4° C.

In an embodiment a method of preparing 12 mLs of a Hunter Substrate (HS)with a molecular weight of about 4 MU-αIdoA-2S-477 g/mol and aconcentration of about 1.25 mM, may include the following protocol. Addabout 3 mL of substrate buffer (HSB) to a vial containing about 5 mg of4 MU-αIdoA-2S, substantially dissolve the substrate and transfer thesolution to about a 10 mL tube; rinse vial with about 3 mL substratebuffer (HSB) and add this solution to the 10 mL tube; add about 2.33 mLsubstrate buffer (HSB) to the 10 mL tube which now contains about 8.33mL of 1.25 mM substrate solution (HS); repeat the process to produceabout 8.33 mL of 1.25 mM substrate solution (HS) using another 5 mgvial; and aliquote.

In an embodiment a method of preparing Hunter Enzyme Buffer (HEB) mayinclude the following. Preparing about 100 mg/mL BSA in molecularbiology grade water, by adding about 1 mL molecular biology grade waterto about 100 mg BSA; Preparing about 10 mL of HEB (=0.05 M sodiumacetate, pH about 5.0; 0.01% Tween® 20, 1 mg/ml BSA), by placing about 5ml of plain 0.1 M acetate buffer (pH about 5.0) (HB) in a about 15-mLcentrifuge tube; Add about 5 mL molecular biology grade water; Add about10 ul of 10% Tween® 20; Add about 100 ul of 100 mg/ml BSA in molecularbiology grade water; cap and swirl for about 1 minute, trying to avoidfoam formation; and store at about 4° C.

In an embodiment a method of preparing about 1.8 mLs of a Hunter Enzyme(HE) at a concentration of 10 μg/mL, may include the following protocol.Obtain about 10 μg vial of Iduronidase enzyme, measure the volume ofenzyme in the vial, subtract the volume of enzyme from 1000 and add thedifference of HEB to produce about 1000 μL of HE; vortex gently until itdissolves substantially completely in the solution, preferably avoidingcreating foam; repeat the process using one more vial of Iduronidaseenzyme to produce about 1000 μL (total volume=2000 μL); aliquote; andstore at −80° C.

In an embodiment a method of preparing about 1080 μL Gaucher Substrate(GS) with a molecular weight of about 4-MU-β-Gluc-338.3 g/mol, and aconcentration of about 0.7 mol/L (700 mM), may include the followingprotocol. Weigh 256 mg of 4-MU-β-Gluc and dissolve in about 1080 μL ofDMSO; vortex thoroughly until the substrate is substantially completelydissolved in the solution; and aliquote.

In an embodiment a method of preparing a Gaucher Buffer (GB) may includethe following steps. Tare an empty glass containing a magnetic stir barand record the tare; in a tared weighing boat, weigh about 2.10 g(+/−0.05 g) of citric acid monohydrate and transfer quantitatively intothe tared beaker containing the stirbar (rinse the boat into the bottle,using about 3×˜5 mL of molecular biology grade water); in another taredweighing boat, weigh about 2.76 g (+/−0.05 g) of sodium phosphatemonohydrate, and transfer quantitatively into the beaker, using about3×˜5 mL to rinse the boat; Add about 50 mL of molecular biology gradewater into the beaker. (total volume in bottle at this point preferablyabout 75-85 mL); magnetically stir until the solids are substantiallycompletely dissolved (about 10 min); tare the beaker with its contents,and, while stirring, add NaOH (2M) until the pH reaches a value of about5.20 (+/−0.05), as measured with a pH meter freshly calibrated betweenpH about 4.00 and 7.00; once the desired pH is reached, measure theweight of the beaker with its contents again, determine the weight ofNaOH (2M) added, record this value in the batch traveler; to determinethe total weight of chemicals added to the beaker, subtract the initialtare weight (=empty bottle+stirbar) from the final total weight,determine the difference between this weight and about 100 g, add thisamount of molecular biology grade water to the beaker; stir for about 2min, measure the final pH and record the value in the batch traveler(this constitutes plain citrate/phosphate buffer (about pH 5.2)); inabout a tared 50-mL centrifuge tube, weigh directly about 0.540 g(+/−0.005 g) of sodium taurocholate, add about 36.0 g (+/−0.3 g) ofplain citrate/phosphate buffer (pH 5.2); cap and vortex for about 4×10 s(this yields a final taurocholate concentration of about 1.5% w/v);measure the final pH with a pH meter calibrated between pH of about 4.00and 7.00, record the final value in the batch traveler (it preferably isat a pH of about 5.20 (+/−0.05)); add about 100 μL of 10% Tween® 20 tothe final solution and mix; and aliquote.

In an embodiment a method of preparing an extraction buffer (EXT) mayinclude the steps of, obtaining about 5 mL of 10% Tween® 20 solutionfrom a previous preparation; and mixing about 5 mL of 10% Tween® 20solution into about 495 mL of molecular grade water to result in about0.1% Tween® 20 solution (EXT).

In an embodiment a method of preparing a stop buffer (STB), may includethe following steps. Tare about a 250-ml plastic bottle fitted withabout a 1″ magnetic stirbar; Weigh about 1.058 g of sodium bicarbonate(MW 84.01) into the bottle; bring the volume to about the 40-45 mL rangeby adding molecular biology grade water; magnetically stir thoroughlyuntil the powder dissolves substantially completely; using a pH meterfreshly calibrated between pH of about 7.00 and 10.00, measure the pHwhile adding NaOH (1 M) to the solution under agitation until the pHreaches about 10.00 (+/−0.05); bring the final volume of bottle contentsto about 63.0 mL by adding molecular biology grade water; add about 63μL of 10% Tween® 20 to the bottle, stir for about 5 minutes; measure thefinal pH, and record it (it should be at pH of about 10.00+/−0.05); andstore at about room temperature.

In an embodiment a method of preparing a calibrant (CAL), may includethe following steps. Dissolve about 60 mg of 4-MU sodium salt in about10 mL of molecular grade DMSO; vortex thoroughly until it dissolvessubstantially completely into solution to obtain about 30 mM of 4-MUsolution in DMSO; make a dilution by mixing about 100 μL of 30 mM stocksolution with about 900 μL of DMSO, repeat this about 3 times resultingin about 30 μM 4-MU solution in STB; mix about 100 μL of 30 μM 4-MUsolution with about 19.9 mL of STB to result in about 0.15 μM of 4-MUsolution in STB which is used as the CAL; aliquote; and store at about−80° C.

Sample and QC DBS Preparation

Control DBS samples (“high” and “low” QC spots) may be obtained fromU.S. Centers for Disease Control (CDC), Atlanta Ga. An on-bench protocolfor preparation of DBS extracts from QC spots and patient DBS samplesincludes the following steps:

-   -   1. Punch a 3.2 mm punch from each DBS (e.g. 12 DBS samples)        using a manual or automatic puncher and place each punch into a        separate well of a round bottomed 96-well plate (e.g.,        Fisherbrand® 96-well plates);    -   2. Using a 20-200 μL multi-channel pipette, add 100 μL of        extraction buffer (EXT; Molecular grade water with 0.1%        Tween® 20) to each well that contains a DBS punch;    -   3. Cover the wells with a clear adhesive foil; and    -   4. Incubate the DBS punches for 30 minutes on a plate shaker at        room temperature to extract the DBS samples.

During extraction of the DBS samples, the droplet actuator andinstrument may be prepared to run the multiplexed assay.

Droplet Actuator

FIG. 24 illustrates a top view of an example of an electrode arrangement2400 of a droplet actuator configured for performing multiplexed Pompe,Fabry and Hunter's assays. The droplet actuator may include a bottomsubstrate (not shown) and a top substrate (not shown) that are separatedby a gap. Electrode arrangement 2400 may be disposed on the bottomsubstrate. The gap is filled with a filler fluid, such as silicone oilor hexadecane filler fluid. In one example, the filler fluid is 5 cStSilicone oil with 0.1% Triton X15. A spacer (not shown) is providedbetween the bottom substrate and top substrate to determine the heightof the gap therebetween and define fluid dispensing reservoirs. Openingsin the top substrate (not shown) are provided for introduction of oilfiller fluid into the cartridge and dispensing reagent and sample fluidsinto each on-chip dispensing reservoir. The fluid dispensing reservoirsare aligned with a dispensing electrode and may be used to deliver aliquid through a fluid path into the gap of the droplet actuator andinto each on-chip dispensing reservoir electrode.

Electrode arrangement 2400 includes multiple fluid dispensing reservoirselectrodes, which may, for example, be allocated as sample dispensingreservoirs electrodes 2410 (e.g., 12 sample dispensing reservoirselectrodes 2410) for dispensing sample fluids (e.g., dried blood spotextracts) and reagent dispensing reservoirs electrodes 2412 (e.g., 8reagent dispensing reservoirs 2412 a through 2412 h) for dispensingreagent fluids. In one example, reagent dispensing reservoir electrode2412 a may be used to dispense a substrate formulation for a Pompe assay(POM); reagent dispensing reservoir electrode 2412 b may be used todispense a substrate formulation for a Fabry assay (FAB); reagentdispensing reservoir electrode 2412 c may be used to dispense asubstrate formulation for a Hunter assay (HUN); reagent dispensingreservoir electrode 2412 d may be used to dispense extraction buffer;reagent dispensing reservoir electrodes 2412 e through 2412 g may beused to dispense reaction stop buffer; and reagent dispensing reservoirelectrode 2412 h may be used to dispense a calibration fluid forinstrument calibration. A summary of reservoir allocation with referenceto FIG. 24 is shown in Table 11.

TABLE 11 Reservoir allocation with reference to FIG. 24 SAMPLE RESERVOIRREAGENT (reservoirs 2410) SAMPLE RESERVOIR REAGENT S1 QC-H R1 (reservoir2412a) POM S2 N1 R2 (reservoir 2412b) FAB S3 N2 R3 (reservoir 2412c) HUNS4 N3 R4 (reservoir 2412d) EXT S5 N4 R5 (reservoir 2412e) STB S6 N5 R6(reservoir 2412f) STB S7 N6 R7 (reservoir 2412g) STB S8 N7 R8 (reservoir2412h) CAL S9 N8 S10 N9 S11 N10 S12 QC-L

Sample dispensing reservoir electrodes 2410 and reagent dispensingreservoir electrodes 2412 are interconnected through an arrangement,such as a path or array, of droplet operations electrodes 2414 (e.g.,electrowetting electrodes). Droplet operations are conducted atopdroplet operations electrodes 2414 on a droplet operations surface.Electrode arrangement 2400 includes a reaction zone 2416. Electrodearrangement 2400 also includes a detection spot 2418.

The droplet actuator that includes electrode arrangement 2400 isdesigned to fit onto an instrument deck that houses extra-dropletactuator features such as one or more thermal controllers (heaterassemblies) for controlling the temperature within certain processingzones, and a fluorimeter for fluorescence detection. In one example, thedroplet actuator is designed to fit into an NBS-LSD100 analyzerinstrument that is connected to a desktop computer with SpotLogicsoftware installed. The droplet actuator may be provided and stored in avacuum sealed aluminum pouch prior to use.

Assay Protocol

A high level overview of an example of the steps used to prepare adroplet actuator and run a digital microfluidic protocol for multiplexedPompe, Fabry and Hunter's assays is shown in Table 12 below. In thisexample, the instrument is an NBS-LSD100 analyzer that is connected to adesktop computer with SpotLogic software installed.

TABLE 12 Overview of multiplexed Pompe, Fabry and Hunter assay protocolSNo. Step Description 0 Initialization Hardware components initialized.Thermal control set to heat the cartridge to 37° C. Wait for setpoint tobe reached. Read and verify actual voltage and temperature. 1 Oilloading Add 1.9 mL of OIL into the cartridge. 2 Sample and Add 3.4 μL ofsample and 6.6 μL of reagents reagent loading 3 Calibration Low Detectbackground fluorescence of stop buffer 4 Calibration High Detectbackground fluorescence of 0.15 μM of CAL 5 Substrate QC Detectfluorescence of (EXT + POM/FAB/HUN + STB) to determine quality ofsubstrate formulations 6 Set up reactions Merge unit droplet of each DBSextract with unit droplet of POM/FAB/HUN 7 Incubate Incubate thereaction droplets for 1 hours at 37° C. 8 Detection of Merge each Pompeassay droplet with unit Pompe droplet of STB and detect end point assaydroplets fluorescence 9 Detection of Merge each Fabry assay droplet withunit Fabry droplet of STB and detect end point assay dropletsfluorescence 10 Detection of Merge each Hunter assay droplet with unitHunter droplet of STB and detect end point assay droplets fluorescence

Initialization of the instrument (referring to Step 0 of Table 12)includes the following steps:

-   -   1. Prior to starting each run, insert a “test cartridge”        provided with the instrument into the instrument deck as        specified in the instrument manual;    -   2. Engage the test cartridge to the voltage I/O pins by lowering        the blue lever on the NBS-LSD 1000 instrument; and    -   3. Open the SpotLogic™ software application and click “Test” to        test for the electrowetting effector, fluorimeter and the        thermal controller.

Loading filler fluid in the droplet actuator (referring to Step 1 ofTable 12) includes the following steps:

-   -   1. Remove a droplet actuator from its vacuum sealed aluminum        pouch and place it flat on a bench surface;    -   2. Using a 1000 μL pipette (e.g., Fisherbrand® aerosol pipette        tip) dispense 930 μL of filler fluid (e.g., 5 cSt Silicone oil        with 0.1% Triton® X15) into the droplet actuator through the 2        mm oil-input opening in the top substrate. Proceed slowly in        order to avoid formation of air bubbles. This process is        repeated twice so that the total volume of oil in the cartridge        is 1.86 mL;    -   3. Remove any air bubbles that are formed in the reservoirs by        carefully sucking out air and some oil from the reservoirs using        a 20 μL pipette;    -   4. Top the remaining 2 mm openings with 30-50 μL of oil so that        there is excess oil in all the openings. The oil-filled        cartridge is left flat on the bench surface for 3 minutes to        test for any oil leaks through the bond line between the top        substrate and the bottom substrate (e.g., a PCB). If oil is        leaking from the bond line between the top substrate and bottom        substrate, reject the droplet actuator and discard it into a        biohazard bag. Obtain a new droplet actuator and load the filler        fluid; and    -   5. After loading the filler fluid in the droplet actuator and        testing all the main components of the NBS-LSD100 analyzer (Step        0 of Table 12), select the instrument serial number in the        software where intend to perform the testing and click “Start”.        Follow the prompts on the software and install the droplet        actuator in the instrument deck by lifting the blue lever. Stop        when the software prompts “Load Samples”.

Loading reagents and sample fluids in the droplet actuator (referring toStep 2 of Table 12) includes the following steps:

-   -   1. Following the instructions on the software, load the samples        and reagents into the designated reservoirs using a 20 μL        pipette. Reservoir allocation as set-up in SpotLogic™ software        is described in reference to FIG. 24 and Table 11.    -   2. Load 3.4 μL of DBS extracts in the sample reservoirs as        defined in the template in the SpotLogic™ software;    -   3. Load 6.6 μL of reagent fluids (POM, FAB, HUN, EXT, CAL, and        STB) into their respective reagent dispensing reservoirs as        specified by the SpotLogic™ software. Referring to Table 11, the        order of reagent loading is STB in reservoirs R5, R6 and R7, CAL        in reservoir R8, EXT in reservoir R4, POM in reservoir R1, FAB        in reservoir R2 and HUN in reservoir R3;    -   4. A loading check (e.g., presence of air bubbles, volume) is        performed visually during the loading of each reservoir. During        reagent and sample loading, filler fluid (oil) may seep out of        the reservoir openings in the top substrate. Seepage of oil may        cause the formation of air bubbles in the reservoirs. To        maintain the level of filler fluid and avoid the formation of        air bubbles, about 30 μL to 50 μL of oil may be added to all        reservoir openings. Expertise in fluid loading and visual        inspection may be acquired and assessed, for example, during a        training session on the instrumentation and NBS assay protocol;    -   5. After loading all the samples and reagents in their        respective reservoirs, check the oil level again and confirm        that all information that was entered is correct; and    -   6. Start the assay by clicking the “Start” button in the        software.

Running the assay (referring to Steps 3 through 10 of Table 12) includesthe following steps:

-   -   1. The initial steps of the assay, calibration (Steps 3 and 4)        and substrate QC (Step 5) are monitored to identify any “flags”.        A flag may be generated due to malfunctioning of either the        droplet actuator or the instrument. If any flags are observed,        stop the assay, remove the cartridge and initiate a new run;    -   2. If no flags are observed, close the instrument lid and allow        about 2.5 hours to obtain 36 data points (3-plex assays on 12        samples); and    -   3. After completion of the run, lift the blue lever to disengage        the droplet actuator from the I/O connector pins and carefully        remove the droplet actuator from the instrument deck. Discard        the droplet actuator into a bio-hazard bag for disposal.        Hunter's Assay Using DBS Samples on a Droplet Actuator

The invention provides a digital microfluidic platform and assay methodsusing dried blood spot (DBS) samples for detection of the lysosomalstorage disorder Hunter's syndrome (mucopolysaccharidosis II). Hunter'ssyndrome is caused by deficient activity of the lysosomal enzymeiduronate-2-sulfate sulphatase (IDS). The substrate fluid for IDS in anenzymatic assay may, for example, be the fluorogenic substrate4-methylumbelliferyl-α-L-iduronide-2-sulfate (MU-αIdoA-2S). The use ofMU-αIdoA-2S as a fluorescent substrate to measure the activity of IDSrequires the sequential action of a second enzyme, α-L iduronidase, toconvert the product of the sulphatase, 4-methylumbelliferyl-α-L-iduronicacid, into iduronic acid and 4-MU as described in reference to FIG. 1.The microfluidic protocol is a single-step homogenous assay usingpurified recombinant iduronidase that is performed at a single pH (i.e.,pH from about 4.5-5.5, or from about 4.8-5.2, or from about 4.9-5.1, orabout 5.0), with a time to result of 8 hours or less. In a preferredembodiment, the microfluidic protocol is performed with a time to result(from extraction of DBS to result) of about 2 hours or about 90 minutesor less. Other embodiments may make use of the alternative substratesdescribed herein.

The digital microfluidics platform may, for example, include adisposable, self-contained droplet actuator in which the enzymaticreaction is performed in aqueous droplets within an oil filled gap ofthe droplet actuator. Samples and assay reagents (e.g., substrate, stopbuffer) are manipulated as discrete droplets upon an electrode array(digital electrowetting). The electrode array may, for example, befabricated on a printed-circuit-board (PCB) and enclosed in an oil(e.g., polydimethylsiloxane 2 cst, Gelest, Inc.) filled dropletactuator. The droplet actuator may be designed to fit into the deck of,or otherwise electronically coupled to, an instrument that incorporatesall control and detection capabilities. The interface between thedroplet actuator and instrument device may, for example, be provided byspring loaded connector pins between the device and contact pads on thedroplet actuator. Samples and reagents are introduced into the dropletactuator through fluid loading ports and on-chip reservoirs. The dropletactuator may be inserted into the device which automatically performsall assay manipulations including dispensing required volumes of samplesand reagents, mixing, incubation, reaction termination and detection. Adroplet may be selectively dispensed from any reservoir, transported,combined with other droplets and divided thereby replicating all of therequired liquid manipulations to perform an enzymatic assay. The volumeof a single droplet on the droplet actuator may, for example, be 300 nL.Detection of the fluorescent sodium umbelliferone product (4-MU; 360 nmexcitation, 460 nm emission) may, for example, be achieved using afluorimeter module in an epi-illumination configuration mounted directlyabove a droplet actuator detection electrode. Filtered excitation lightfrom an ultraviolet LED is directed at the sample and collected backalong the same optical path. Fluorescent light greater than 427 nmwavelength passes through a dichroic beam splitter and an emissionfilter to a photodiode. The LED excitation and collection electronicsmay be in a lock-in configuration to reduce background noise.Specifically, the LED oscillates at 1 kHz and the photodiode signal issampled at 32 kHz for one second. The reported fluorescent signal isobtained by examining the magnitude of the collected signal at 1 kHzusing a fast Fourier transform.

FIG. 25 shows a plot 2500 of IDS activity in a Hunter's assay performedon the digital microfluidic platform using extracts from DBS samples. Astock solution of recombinant human α-L-iduronidase (>7.5 nmoles/min/μg;10 μg/ml iduronidase in 0.05 M sodium acetate, 0.5 M sodium chloride, 1mg/ml BSA, 0.01% Tween® 20, pH 5.0 buffer) was prepared and stored in 10μL aliquots at −80° C. Iduronidase-2-sulfate sulfatase (IDS) assaysolution was prepared fresh by thawing an aliquot of iduronidase. Unusediduronidase was discarded and not refrozen. Dried blood spots (3 mmpunches) from presumed normal individuals and from Hunter affectedindividuals were reconstituted on-bench by gentle mixing in 100 μL 0.1%Tween® 20 in microfuge tubes for 30 minutes at room temperature.Prepared reagents and DBS samples were loaded onto fluid dispensingreservoirs of a droplet actuator.

The digital microfluidic protocol for measuring IDS activity includedthe following steps: One droplet of reconstituted DBS extract wascombined using droplet operations with one droplet of assay solution(1.125 mM 4-methylumbelliferyl-α-L-iduronate-2-sulfate, 1 μg/mlrecombinant human α-L-iduronidase, 0.1 M sodium acetate, and 0.01 M leadacetate, pH 5.0) to yield a 2× reaction droplet. The 2× reaction dropletwas split using droplet operations to yield two 1× reaction droplets.One 1× reaction droplet was immediately combined using dropletoperations with one 1× droplet of termination buffer (0.2 M sodiumbicarbonate, 0.01% Tween® 20, pH 10.0) and transported to the detectorelectrode to measure the fluorescent signal at zero time. The second 1×reaction droplet was incubated on the droplet actuator for one hour at37° C. After the incubation period, the 1× reaction droplet was combinedwith a 1× droplet of termination buffer and transported to the detectorelectrode to measure the fluorescent signal at time t=1 hour. Theactivity of IDS is expressed in micromoles product formed per hour perliter blood. The IDS activity was calculated based on a 3 mm DBS punchcontaining 3.1 μL of blood. Assay calibration was performed on thedroplet actuator using sodium 4-methylumbelliferone in 0.2 M sodiumbicarbonate, 0.01% Tween® 20, pH 10.0 termination buffer as a standard.

In this example, an iduronidase concentration of 1 μg/ml in the IDSassay was sufficient to liberate 4-methylumbelliferone (4-MU) from4-methylumbelliferyl-α-L-iduronic acid after IDS removal of the sulfatemoiety from 4-methylumbelliferyl-α-L-iduronide-2-sulfate (data notshown). Dilution (31-fold) of blood during extraction of the DBS and thepresence of 10 mM lead acetate in the substrate buffer as in section7.14.1 was sufficient to substantially prevent inhibition ofiduronidase-2-sulfate sulfatase activity by anions such as chloride,phosphate and sulfate in the reaction droplet.

The IDS activity in extracts of DBS from random newborns (n=105 randomnewborn DBS samples) and Hunter patients (n=6 affected DBS samples) wasmeasured by two operators using two different instruments and dropletactuators. The data show the IDS activity in the Hunter patients (range,0-2.7; mean, 1.1; median, 1.0 μmol/h/L blood with a standard deviationof 1.48) was well below and clearly separated from the IDS activityfound in presumed normal newborns (range, 10.4-56.9; mean, 22.9; median20.2 μmole/h/L blood with a standard deviation of 9.7). It is not knownif any of the DBS from the random newborn pool were from carriers of theHunter trait.

Single-Step Assay for Hunter's Syndrome

The invention provides an enzymatic assay for Hunter's Syndrome. Themicrofluidic protocol is a single-step homogenous assay using purifiedrecombinant iduronidase that is performed at a single pH (i.e., pH 5.0)with a time to result of 8 hours or less. In one embodiment, on-chipreaction volumes i.e., 2 μL Hunter enzyme and 18 μL Hunter substrate maybe scaled to on-bench volumes, i.e., 10 μL Hunter enzyme and 90 μL ofHunter substrate. The incubation time for sufficient enzymatichydrolysis of substrate and time to result may be selected forapplications. The assay may, for example, use extracts prepared fromdried blood spot (DBS) samples to test for Hunter's disease. A stocksolution of Hunter substrate (HS;4-methylumbelliferyl-α-L-iduronide-2sulfate Na₂; Moscerdam Substrates)may be prepared in Hunter substrate buffer (HSB; 0.1 M Sodium Acetate,10 mM lead (II) acetate (Sigma Aldrich), 0.01% (w/v) Tween® 20). The pHof the Hunter substrate buffer (HSB) may from about 4 to about 6,preferably from about 4.5 to about 5.5, ideally about 5. A stocksolution of Hunter enzyme formulation (HE; recombinant humanα-L-iduronidase; 10 μg/20 μL; R&D Systems) may be prepared in Hunterenzyme buffer (HEB; 0.05 M Sodium Acetate, 0.01% (w/v) Tween® 20, 1mg/mL bovine serum albumin (BSA); Sigma Aldrich). The pH of the Hunterenzyme buffer (HEB) may from about 4 to about 6, preferably from about4.5 to about 5.5, ideally about 5. Stock solutions may be prepared,aliquoted, and stored at −80° C. until use.

Preparation of the Hunter substrate formulation (HS) for an on-benchHunter assay includes the following steps:

-   -   1. Add 3 mL of Hunter substrate buffer (HSB; 0.1 M Sodium        Acetate, pH 5.0, 10 mM lead (II) acetate (Sigma Aldrich), 0.01%        (w/v) Tween® 20) to a 5 mg vial of        4-methylumbelliferyl-α-L-iduronide-2sulfate Na₂. Dissolve and        transfer the solution to a 10 mL conical, polystyrene tube        wrapped in foil;    -   2. Rinse the vial by adding a second 3 mL of HSB to the vial and        mix vigorously. Transfer this solution to the same 10 mL conical        tube;    -   3. Add 2.33 mL of HSB to the same 10 mL conical tube to yield a        total volume of 8.33 mL.    -   4. Aliquot 105 μL of the solution to individual microfuge tubes;        and    -   5. Store at −80° C. protected from light.

Preparation of the Hunter enzyme (HE) formulation for the Hunter assayincludes the following steps:

-   -   1. Add 20 μL of Iduronidase to 980 μL of Hunter enzyme buffer        (HEB; 0.05 M Sodium Acetate, pH 5.0, 0.01% (w/v) Tween® 20, 1        mg/mL bovine serum albumin (BSA; Sigma Aldrich));    -   2. Gently vortex until completely dissolved;    -   3. Aliquot 13 μL of the solution to individual microfuge tubes;        and    -   4. Store at −80° C.

An assay protocol for Hunter's syndrome includes, but is not limited to,the following steps:

-   -   1. Extract one 3 mm DBS sample punch in 100 μL of extraction        buffer (0.1% w/v Tween® 20 in molecular grade water) for 30 min        at room temperature on a shaking platform at 1400 rpm;    -   2. At the end of the extraction, transfer the liquid to a 1.5 mL        microfuge tube;    -   3. Test each sample in duplicate. Each aliquot of HS and HE is        sufficient for testing 5 samples in duplicate, 10 reactions        total;    -   4. Prepare Hunter working substrate solution (HWSS) by combining        99 μL of HS with 11 μL of HE. Mix well and protect from light;    -   5. In a Costar black, half-area microtiter plate, combine 10 μL        of DBS extract and 10 μL HWSS. Avoid using the wells on the edge        of the plate (i.e., rows A and H and columns 1 and 12);    -   6. Seal the plate with adhesive plate sealer and wrap the plate        in aluminum foil;    -   7. Incubate the reactions at 37° C. for 20 hrs;    -   8. At the end of the incubation period, stop the reaction with        50 μL of stop buffer (0.2 M sodium bicarbonate, pH 10.1) and mix        well; and    -   9. Read fluorescence at 360/460 excitation/emission at a gain of        60.

FIG. 26 shows a bar graph 2600 of fluorescence data of a single-stepon-bench assay for Hunter's syndrome. DBS extracts were prepared fromquality control (QC) samples, i.e., base pool (BP), low (L), medium (M)and high (H) activity samples. The base pool (BP) QC sample was preparedfrom a pool of leukoreduced human red blood cells that was adjusted withheat-treated serum to a hematocrit of 50%. The High (H) activity QCsample was prepared from pooled cord blood that was adjusted withheat-treated serum to a hematocrit of 50%. The medium (M) activity QCsample was prepared by using 50% base pool (BP) and 50% high (H)activity sample. The low (L) activity QC sample was prepared by using95% base pool (BP) and 5% high (H) activity sample. The BP sample isused as a control for hydrolysis non-specific to white blood celllysosomal enzymes. The data show a strong signal and clear separationbetween L, M and H samples.

FIG. 27 shows a bar graph 2700 of another example of fluorescence dataof a single-step on-bench assay for Hunter's syndrome. In this example,DBS extracts were prepared from BP, L, M, and H QC samples, 10 normal(N; unaffected) DBS samples and 2 Hunter's (MPS-II; affected) DBSsamples. The data show a strong signal and clear separation betweennormal and affected (MPS-II) samples. Higher levels of enzyme activityin the normal samples relative to QC samples may be due to the presenceof enzyme activity in the non-heat treated normal samples. The level ofenzyme activity in the non-heated treated Hunter's samples isessentially reduced to BP levels.

Assay for Fabry Disease

The invention provides an enzymatic assay for Fabry disease (describedin reference to Tables 10 and 12 and FIG. 24) may be adapted to anon-bench protocol. In one embodiment, the assay uses extracts preparedfrom dried blood spot (DBS) samples to test for Fabry disease. Stocksolutions for Fabry substrate, 4-Methylumbelliferylα-D-galactopyranoside (40MUGal; MW=338.3 g/mol; Sigma) may be preparedin Dimethly Sulfoxide (DMSO, 99.9%) at a concentration of 700 mM. Stocksolutions of Fabry inhibitor (750 μM of N-Acetyl-D-Galactosamine; Sigma)may be prepared in molecular biology grade water. Fabry substrate andinhibitor stock solutions may be prepared, aliquoted and stored at −80°C. until use. The on-bench assay may, for example, be performed inmulti-well microtiter plates (e.g., Costar black half-area plates). Amicrotiter plate reader (e.g., Biotek KC4 plate reader) may be used forfluorescence detection.

An on-bench assay protocol for Fabry disease includes, but is notlimited to, the following steps:

-   -   1. Extract one 3 mm DBS sample punch in 100 μL of extraction        buffer (0.1% w/v Tween® 20 in molecular grade water) for 30 min        at room temperature on a shaking platform at 1400 rpm;    -   2. At the end of the extraction, transfer the liquid to a 1.5 mL        microfuge tube;    -   3. Prepare a Fabry working substrate solution (FWS) by combining        78.6 μL Fabry enzyme buffer (0.04 M Sodium Acetate with 0.01%        (w/v) Tween® 20, pH4.6) with 20 μL Fabry inhibitor stock        solution and 1.4 μL Fabry substrate stock solution;    -   4. In a Costar black, half-area microtiter plate, combine 10 μL        of DBS extract and 10 μL Fabry working substrate solution (FWS).        Run each sample in duplicate;    -   5. Seal the microtiter plate with adhesive plate sealer and wrap        the plate in aluminum foil;    -   6. Incubate the reactions at 37° C. for 20 hrs;    -   7. At the end of the incubation period, stop the reaction with        50 μL of stop buffer (0.2 M sodium bicarbonate, pH 10.1) and mix        well; and    -   8. Read fluorescence at 360/460 excitation/emission at a gain of        75.        Enzyme-Mediated Release of Nucleic Acids from DBS

The use of dried blood spots (DBS) collected on filter paper for nucleicacid-based testing of infectious diseases, newborn testing and SCIDS iswidespread in the public health community. In nucleic acid-based testingprotocols, such as PCR, the entire DBS sample is inserted into a PCRtube and amplified. For nucleic acid testing on a droplet actuator, theDBS sample may be extracted from the filter paper prior to analysis.However, the release of nucleic acids (e.g., DNA and RNA) from the DBSsamples is difficult and inefficient when using chemical extractionmethods and may result in gross underestimations of target nucleic acidconcentrations by up to several orders of magnitude. The inefficiency ofnucleic acid extraction from DBS samples has been attributed to thephysical interaction (e.g., intertwined) of the nucleic acid moleculeswith the fibers of the filter paper.

The use of DBS collected on filter paper for enzyme-based testing ofinfectious diseases, newborn testing and SCIDS is widespread in thepublic health community. For enzyme-based testing on a droplet actuator,the DBS sample may be extracted from the filter paper prior to analysis.However, the release of enzymes from the DBS samples is difficult andinefficient when using chemical extraction methods and may result ingross underestimations of target enzyme acid concentrations by up toseveral orders of magnitude. The inefficiency of enzyme extraction fromDBS samples has been attributed to the physical interaction (e.g.,intertwined) of the enzyme molecules with the fibers of the filterpaper.

The present invention provides methods for using enzymes to releasenucleic acids in DBS samples collected on filter paper. In oneembodiment, a cellulose degrading enzyme, such as cellulase, may used topartially or totally solubilize the filter paper matrix to releasesubstantially all of the nucleic acid in the sample into an extractionbuffer. In one example, the cellulase complex from Trichoderma reesei(formerly T. viride) may be used to release nucleic acids in DBS samplescollected on filter paper. The cellulase complex from T. reeseiquantitatively converts cellulose to glucose. An example of an on-benchprotocol to release nucleic acids from a DBS collected on filter papermay include the following: The DBS sample may be washed (e.g., two orthree times) with an aqueous buffer to remove soluble PCR inhibitorycomponents from the DBS. The washed DBS sample may be incubated with acellulose degrading enzyme, such as cellulase from T. reesei, to releasenucleic acids in the DBS. Nucleic acids in the sample may beconcentrated using a magnetic bead-based protocol to reduce the samplevolume prior to loading the extracted blood sample onto a dropletactuator. The concentrated DBS extract may be loaded onto a sampledispensing reservoir of a droplet actuator and dispensed forquantitative PCR analysis using a digital microfluidic protocol.

The method may be used for the enzymatic assays described herein. In oneembodiment, a cellulose degrading enzyme, such as cellulase, may used topartially or totally solubilize the filter paper matrix to releasesubstantially all of the enzyme in the sample into an extraction buffer.

Digital Microfluidic Platform for Bilirubin, G6PD and CH Newborn Testing

The present invention provides a digital microfluidic platform and assaymethods for multiplexed testing of newborns. The digital microfluidicplatform includes a multi-well droplet actuator that may be configuredfor one or more molecular assays for newborn testing. Because of thesoftware programmability of digital microfluidics, most of theparameters varied between and within protocols, such as incubationtimes, sequences of reagent additions, and thermal programs, may bereadily adapted to different assay protocols.

In one embodiment, the digital microfluidic platform may be configuredfor multiplexed testing of newborns that are at risk forhyperbilirubinemia and its most common underlying pathological causes,glucose-6-phosphate dehydrogenase (G6PD) deficiency, and congenitalhypothyroidism (CH). On-bench assays for determination of totalbilirubin, G6PD activity and CH (i.e., TSH assay) may be described andimplemented on a droplet actuator as discrete step-by-step droplet-basedprotocols. Assay protocol parameters may, for example, be selected forlinearity, increased sensitivity (limit of detection), specificity,droplet carryover, and rapid time-to-result.

The droplet actuator may be designed to fit into, or otherwise beelectrically coupled to, an instrument deck that that houses othercomponents that are external to the droplet actuator. Examples ofexternal components include, but are not limited to, one or more magnetsfor immobilization of magnetically responsive beads, one or more heaterassemblies for controlling the temperature within certain processingzones, and a detection system.

Total Bilirubin Assay

Assays for determination of total bilirubin (serum or plasma) levels maybe adapted for use on a droplet actuator. In one example, the totalbilirubin assay kit (B576-480) available from Teco Diagnostics may beadapted for use on a droplet actuator. The total bilirubin assay is acolorimetric assay based on the reaction between bilirubin anddiazotized sufanilic acid to produce azobilirubin which has anabsorbance maximum at 560 nm wavelength in the presence ofdimethylsulfoxide (DMSO) solvent. The kit includes the followingreagents: Total Bilirubin Reagent (sulfanilic acid 32 mM, hydrochloricacid 165 mM, DMSO 7 M (55% w/v)); and Bilirubin Nitrite Reagent (sodiumnitrite 60 mM); Bilirubin Calibrator (20 mg/dLN-1-naphthylethylenediamine dihydrochloride salt). Working reagents andcalibration solutions were prepared on-bench as follows: Total bilirubinworking reagent was prepared on-bench before each experiment by adding50 μL of sodium nitrite reagent to 1.0 mL of total bilirubin reagent.Bilirubin calibrator solutions were prepared on-bench at 3, 7, 10, 14,and 20 mg/dL by diluting the 20 mg/dL calibrator stock using deionizedwater.

FIGS. 28A and 28B show plots 2800 and 2850 of bilirubin calibrationcurves obtained on-chip and a scatter plot of on-bench values,respectively. Discarded and deidentified pediatric serum samples wereobtained from Duke University (Durham, N.C.) along with the totalbilirubin values. The on-bench reference assay (Duke Method) wasperformed before (e.g., a day before) the on-chip assay. Preparedreagents, calibrators and serum samples were loaded onto fluiddispensing reservoirs of a droplet actuator. The on-chip assay protocolincluded the following steps: For calibration, a 1× droplet ofcalibrator was combined using droplet operations with two 1× droplets ofworking reagent to yield a 3× droplet. The 3× droplet was split usingdroplet operations into a 1× droplet and a 2× droplet. The 1× dropletwas combined with two 1× droplets of working reagent. For serum blank, a1× droplet of serum was combined using droplet operations with two 1×droplets of total bilirubin reagent to yield a 3× droplet. The 3×droplet was split using droplet operations into a 1× droplet and a 2×droplet. The 1× droplet was combined with two 1× droplets of totalbilirubin reagent. For unknown serum bilirubin, a 1× droplet of serumwas combined using droplet operations with two 1× droplets of workingreagent to yield a 3× droplet. The combined droplet was incubated at 37°C. for 5 minutes. The 3× droplet was split using droplet operations intoa 1× droplet and a 2× droplet. The 1× droplet was combined with two 1×droplets of working reagent. The combined droplet was incubated at about37° C. for about 5 minutes. Absorbance was read at 560 nm wavelengthusing a LED-photodiode colorimeter. All experiments were performed intriplicate on three different droplet actuators. For both the on-benchand on-chip experiments, the calibration curve was obtained by linearregression analysis in Microsoft Excel®. The absorbance of the serumblank is subtracted from serum absorbance. The blank corrected serumabsorbance value is used to obtain the unknown bilirubin value using theregression equation. The experiments were performed using electrowettingmediated droplet operations in silicon oil.

The data shows the calibration curve is linear up to 20 mg/dL.Examination of the scatter plot indicates that there is a smallproportional bias in the assay on cartridge when compared to theon-bench reference assay. This may be expected while using diazo methodsfor bilirubin assay. The correlation is good and is may be improved byperforming the reference assay and the on-chip assay at the same time.In this example, there was about a one day delay between the referencetest and on-chip assay. Bilirubin is a very labile analyte and themethod comparison should ideally be performed at the same time. Inanother example, a direct bilirubin test as a marker forhyperbilirubinemia may be adapted for use on a droplet actuator.

G6PD Assay

Neonatal testing test kits for glucose-6-phosphate dehydrogenase (G6PD)deficiency are commercially available and may be adapted for use on adroplet actuator. In one example, the G6PD deficiency neonatal testingtest kit available from Interscientific Inc. may be adapted for use on adroplet actuator. The assay is based on the oxidation ofglucose-6-phosphate to 6-phosphogluconate, and reduction of NADP toNADPH, in the presence of glucose-6-phosphate-dehydrogenase. The NADPHproduced reduces tetrazolium dye (MTT) in the presence of phenazinemethosulfate to produce a colored product with an absorbance peak at 565nm. The kit includes the following reagents: R1 (Elution/Lysis Buffer),R2 (Work Reagent), R3 (Color Reagent), R4 (CRB; Color Reagent Buffer).To prepare the Working Color Reagent, 1 part of CRB (R4) and 10 parts ofColor Reagent (R3) are mixed together on-bench. The kit also includesassay controls representing normal, intermediate and deficient G6PDvalues.

FIG. 29 shows a plot 2900 of the G6PD assay performed on-chip. Pediatricwhole blood samples (n=8 presumed normal samples) were obtained fromDuke University. Prepared reagents, assay controls (normal, intermediateand deficient) and whole blood samples (n=8 presumed normal) were loadedonto fluid dispensing reservoirs of a droplet actuator. The on-chipassay protocol for whole blood samples and controls included thefollowing steps: A 1× droplet of whole blood (or control) was combinedusing droplet operations with three 1× droplets of elution/lysis buffer(R1) and incubated for 1 minute. The combined 4× droplet was split usingdroplet operations to yield a 1× droplet and a 3× droplet. The 1×droplet was combined using droplet operations with a 1× droplet of workreagent (R2) and incubated for 30 seconds. The combined 2× droplet wassplit using droplet operations to yield two 1× droplets. One 1× dropletwas combined using droplet operations with two 1× droplets of workreagent (R2) and incubated for 30 seconds. The combined 3× droplet wassplit using droplet operations into a 1× droplet and a 2× droplet. The2× droplet was transported using droplet operations to a detection spotand absorbance read at 405 nm wavelength for hemoglobin normalization.The remaining 1× droplet was combined using droplet operations with a 1×working color reagent droplet and absorbance read at 560 nm wavelengthin kinetic mode. Sample concentration may be expressed using thefollowing formula:

${{Sample}( {U/{gmHb}} )} = {\frac{\Delta\;{{OD}_{{SAMPLE}\; 560_{nm}}/\Delta}\;{OD}_{{CONTROL}\; 560_{nm}}}{\Delta\;{{OD}_{{SAMPLE}\; 405_{nm}}/\Delta}\;{OD}_{{CONTROL}\; 405_{nm}}} \times \lbrack{Control}\rbrack}$The data shows good separation between deficient, intermediate andnormal samples in the on-chip G6PD assay.Congenital Hypothyroidism (CH) Assay

Congenital hypothyroidism (CH) is currently screened for in some newborntesting programs using a primary thyroid stimulating hormone (TSH)assay. Assays for determination of TSH levels may be adapted for use ona droplet actuator. In one example, the Access HYPERsensitive hTSH kit(Cat #33820) available from Beckman Coulter may be adapted for use on adroplet actuator. The assay is a paramagnetic particle, chemiluminescentassay for the quantitative determination of human thyroid-stimulatinghormone (hTSH). The kit includes the following reagents: paramagneticbeads coated with primary capture antibody, blocking solution andalkaline phosphatase (ALP) labeled secondary antibody. Attoglow(Michigan Diagnostics) may be used as the chemiluminescent substrate.

FIG. 30 shows a plot 3000 of a TSH calibration curve generated on-chip.A reagent mixture was prepared on-bench by mixing equal volumes ofprimary antibody bound to magnetically responsive beads, blockingsolution and secondary antibody labeled with ALP. Prepared reagentmixture, TSH standards (at different concentrations), wash buffer andchemiluminescent substrate were loaded onto fluid dispensing reservoirsof a droplet actuator. The on-chip assay protocol included the followingsteps: A 1× droplet (300 mL) of reagent mixture was combined usingdroplet operations with two 1× droplets of a TSH standard and incubatedfor 4 minutes at room temperature. After the incubation period, themagnetically responsive beads were washed to remove any unboundsecondary antibody by immobilizing the beads to the edge of the 4×reaction droplet using an external permanent magnet and removing theexcess unbound material by activating the adjacent electrodes anddeactivating the intermediate electrode. One 1× droplet ofchemiluminescent substrate was combined with the bead containingdroplet. After 2 minute incubation, end point chemiluminescence wasmeasured using a photon counting photomultiplier tube. A 4-parameterlogistic fit was used to fit the data. The error bars represent standarddeviation from four different assays. Cut-off concentration for TSH thatis used by most testing laboratories (US) is 20 μL U/mL.

In another example, the chemiluminescent TSH assay may be adapted foruse on a droplet actuator as a colorimetric assay. In this example, analkaline phosphatase (ALP) labeled secondary antibody may be used with acolorimetric substrate, such as p-nitrophenol phosphate (detectionwavelength 405 nm), for detection of ALP. Assay parameters may beselected for increased sensitivity in the colorimetric assay. Forexample, the sample volume that is incubated with the primary capturebeads may be increased from about 0.3 μL to about 25 μL. The detectionreaction time may, for example, be increased from about 2 minutes toabout 15 minutes. The assay temperature may, for example, be increasedfrom room temperature to 37° C. The path length at the detection windowmay, for example, be increased from about 0.3 mm to about 1 mm.

Multiplexed Bilirubin, G6PD and TSH Assays on a Droplet Actuator

FIG. 31 illustrates a flow diagram of an example of a protocol 3100 formultiplexed newborn testing for total bilirubin, G6PD and TSH on adroplet actuator. Protocol 3100 may include, but is not limited to, thefollowing steps: In one step, a sample of whole blood (e.g., about 100μL) is collected from a heel stick using a 100 μL capillary bloodcollection tube (e.g., SAFE-T-FILL® collection tubes from RamScientific). In another step, an aliquot of the whole blood (e.g., about10 μL) is transferred to a fluid reservoir of a droplet actuator for theG6PD assay. In another step, the remaining whole blood sample (e.g.,about 90 μL) is centrifuged to obtain serum. In one embodiment, abench-top centrifuge may be used to separate serum from whole blood. Inanother embodiment, an on-chip separation method (e.g., lateral flowfilters) may be used to prepare serum from whole blood. In another step,an aliquot of the serum (e.g., about 30 μL) is transferred to anotherfluid reservoir of the droplet actuator for dispensing for totalbilirubin and TSH assays. For the bilirubin assay, about 0.5 μL of serumis used. For the TSH assay, about 25 μL of serum is used.

FIG. 32 shows a top view of an example of an electrode arrangement 3200of a droplet actuator configured for performing multiplexed totalbilirubin, G6PD and TSH assays on a droplet actuator. In this example,the droplet actuator is configured for performing a 3-plex assay on 6samples. The droplet actuator may include a bottom substrate (not shown)and a top substrate (not shown) that are separated by a gap. The bottomsubstrate may, for example, be a printed circuit board (PCB). Electrodearrangement 3200 may be disposed on the bottom substrate. The gap isfilled with a filler fluid, such as silicone oil. Openings in the topsubstrate (not shown) are provided for introduction of oil filler fluidinto the cartridge and dispensing reagent and sample fluids into eachon-chip dispensing reservoir. The fluid dispensing reservoirs arealigned with a dispensing electrode and may be used to deliver a liquidthrough a fluid path into the gap of the droplet actuator and into eachon-chip dispensing reservoir electrode. In one embodiment, bulk liquidreagents including filler fluid (e.g., oil) may be provided in dropperbottles to facilitate reagent loading and minimize pipetting steps,which may be done robotically. Because precision aliquoting of reagentsis performed inside the droplet actuator using electrowetting-baseddroplet operations, variations in fluid input volume are readilytolerated. Dry reagents may be provided in metered containers in whichthey can be reconstituted and frozen if necessary.

Electrode arrangement 3200 includes multiple fluid dispensing reservoirselectrodes, which may, for example, be allocated as sample dispensingreservoirs electrodes 3210 (e.g., 12 sample dispensing reservoirselectrodes 3210 a through 3210 l) for dispensing sample fluids (e.g.,whole blood, plasma or serum), reagent dispensing reservoirs electrodes3212 (e.g., 12 reagent dispensing reservoirs 3212 a through 3212 l) fordispensing reagent fluids, a wash buffer dispensing reservoir 3214, asubstrate dispensing reservoir 3216, and a waste collection site 3218.In one example, reagent dispensing reservoir electrodes 3212 a through3212 c may be used to dispense reagents for the TSH assay (e.g., primaryand secondary antibodies, calibration adjustor); reagent dispensingreservoir electrodes 3212 d through 3212 f may be used do dispensereagents for the total bilirubin assay (e.g., reagents and calibrator);reagent dispensing reservoir electrodes 3212 g and 3212 h may be useddispense dilution buffer; reagent dispensing reservoir electrodes 3212 ithrough 3212 l may be used to dispense reagents for the G6PD assay(e.g., lysis buffer, reagents, standard). Sample dispensing reservoirs3210 may be used to dispense plasma and whole blood samples from sixdifferent sample sets. For example, sample dispensing reservoirelectrodes 3210 a and 3210 b may be used to dispense plasma and wholeblood, respectively, from a first sample; sample dispensing reservoirelectrodes 3210 c and 3210 d may be used to dispense plasma and wholeblood, respectively, from a second sample; sample dispensing reservoirelectrodes 3210 e and 3210 f may be used to dispense plasma and wholeblood, respectively, from a third sample; sample dispensing reservoirelectrodes 3210 g and 3210 h may be used to dispense plasma and wholeblood, respectively, from a fourth sample; sample dispensing reservoirelectrodes 3210 i and 3210 j may be used to dispense plasma and wholeblood, respectively, from a fifth sample; sample dispensing reservoirelectrodes 3210 k and 3210 l may be used to dispense plasma and wholeblood, respectively, from a sixth sample.

Sample dispensing reservoir electrodes 3210, reagent dispensingreservoir electrodes 3212, wash buffer dispensing reservoir electrode3214, substrate dispensing reservoir electrode 3214 and waste collectionsite 3218 are interconnected through an arrangement, such as a path orarray, of droplet operations electrodes 3220 (e.g., electrowettingelectrodes). Droplet operations are conducted atop droplet operationselectrodes 3220 on a droplet operations surface. A path of dropletoperations electrodes 3220 extending from each sample dispensingelectrode forms dedicated electrode lanes 3222, i.e., 12 dedicatedelectrode lanes 3222 a through 3222 l. Dedicated electrode lanes 3222prove individual reaction zones for processing different samples andsample types (i.e., plasma and whole blood). The use of dedicated lanesfor sample droplets minimizes cross-contamination among samples.

One or more magnets 3224 (e.g., six magnets 3224 a through 3224 f) maybe positioned in proximity to certain droplet operations electrodes 3220for retaining a quantity of magnetically responsive beads. Each magnet3224 may, for example, be a permanent magnet or an electromagnet. Eachmagnet 3224 is positioned in a manner which ensures spatialimmobilization of magnetically responsive beads during washing steps.Mixing and incubations may be performed on certain droplet operationselectrodes 3220 away from the magnet.

Electrode arrangement 3200 includes multiple detection electrodes 3226(e.g., 12 detection electrodes 3226 a through 3226 l). Detectionelectrodes 3226 are positioned in proximity to certain dropletoperations electrodes in each dedicated electrode lanes 3222. The use ofindependent detection electrodes for sample droplets minimizescross-contamination among samples. Detection electrodes 3226 may befabricated as optically transparent electrodes as described in referenceto FIG. 33. Detection electrodes 3226 may be aligned with certainoptical detection channels (e.g., 560 nm channel or 405 nm channel) asdescribed in reference to FIG. 34.

Because of the flexibility and programmability of a droplet actuator,the architecture of the droplet actuator may be readily configured toaccommodate fewer or more samples.

For total bilirubin and G6PD assays, a single point calibration curvemay be generated on-chip as the assays are substantially linear over therequired range. For the TSH assay, a master calibration curve for everydroplet actuator lot number or reagent batch may be generated. Acalibration adjustor may be run on-chip to make adjustments to thecalibration curve. This approach is commonly used in immunoassayanalyzers. Positive and negative controls may be run to identifysystematic errors such as a defective droplet actuator or bad reagentlot. A detailed Design Failure Modes and Effects Analysis (FMEA) may beconducted to identify both external and internal quality control needs.

FIG. 33 illustrates a top view of a portion of a droplet actuator 3300that includes optically transparent detection electrodes suitable fordetection of colorimetric reaction products. Droplet actuator 3300 mayinclude a bottom substrate 3310. Bottom substrate 3310 may, for example,be a PCB. An arrangement, such as a path or array, of droplet operationselectrodes 3312 (e.g., electrowetting electrodes) may be disposed on thebottom substrate 3310. Droplet operations are conducted atop dropletoperations electrodes 3312 on a droplet operations surface. Dropletactuator 3300 may include a detection electrode 3314. A plated throughhole 3316 may be fabricated in detection electrode 3314. Plated throughhole 3316 may, for example, be fabricated as unfilled via holes. Platedthrough hole 3316 may, for example, be about 250 μm in diameter. Platedthrough hole 3316 provides for transmission of light (e.g., from an LED)through bottom substrate 3310. Because plated through hole 3316 issufficiently small relative to the size of detection electrode 3314(e.g., about 1000 μm), electrowetting performance is substantiallyunaffected.

Instrument Platform

In one embodiment the invention provides an instrument platform that issuitable for use in limited resource settings. In one embodiment, theinstrument may be a small, bench-top instrument that is light weight andportable. In another embodiment, the instrument may be a small handhelddevice (e.g., about 10″×5″×5″) that is battery powered (e.g., 8 AAbatteries). The instrument houses components that are external to thedroplet actuator. Examples of external components include, but are notlimited to, one or more magnets for immobilization of magneticallyresponsive beads, one or more heater assemblies for controlling thetemperature within certain processing zones, and a detection system. Adroplet actuator positioned in the instrument deck may be controlledusing an electrical controller, which, for example, has a microprocessorand switching circuitry to control 108 high-voltage electrical I/Os. Theelectrical interface may, for example, use spring-loaded connector pinsto make electrical contact with the droplet actuator. In this example,controllers and software provide switching of 108 high voltage channelsindependently. A high level user-friendly software package with varyinglevels of control for the switching circuitry may be selected to meetrequirements of the end user.

One or more flexible heater circuits and passive cooling within theinstrument may be used to control the temperature within certainprocessing zones on the droplet actuator. Because only certainprocessing zones are heated, power consumption during instrument use issubstantially reduced. The relationship between heater temperature,heater power, and droplet temperature may depend on the thermal contactbetween the heater assembly(s) and the droplet actuator. Heater assemblymaterials may be selected to provide reproducible,low-thermal-resistance contact at the heater assembly/droplet actuatorinterface. For example, thermally conductive elastomers may be used tofacilitate conformation of foil heaters to droplet actuator features. Inanother example, the thermal subsystem may be provided on the dropletactuator. For example, heating elements may be fabricated (e.g., screenprinted) directly on the droplet actuator. Because the heating elementsare provided on the droplet actuator, power consumptions duringinstrument use may be further reduced.

FIG. 34 illustrates a perspective view of an example of a detectionsystem 3400 for detection of colorimetric reaction products. Detectionsystem 3400 may include multiple excitation LEDs 3410 that are alignedwith multiple detectors 3412. Detectors 3412 may, for example, bephotodiodes. In one example, LEDs 3410 are positioned below aninstrument deck 3414 and aligned with detectors 3412 positioned atopinstrument deck 3414. By way of example, detection system 3400 mayinclude four LEDs (e.g., LEDs 3410 a through 3410 d) that are alignedwith four detectors 3412 (e.g., detectors 3412 a through 3412 d). LEDs3410 and detectors 3412 may be selected to provide optical channels forone or more wavelengths of light. For example, LEDs 3410 and detectors3412 may be selected to provide optical channels for the 560 nmwavelength required for bilirubin and G6PD newborn testing assays andfor the 405 nm wavelength for hemoglobin measurements and TSH assay.

A droplet actuator 3416 may be positioned in instrument deck 3414 inproximity to imaging system 3400. In particular, droplet actuator 3416may be positioned such that one or more detection electrodes (e.g., 4detection electrodes; not shown) on droplet actuator 3416 aresubstantially aligned with detection system 3400.

The newborn testing instrument platform of the present invention is alow cost, portable and low maintenance instrument. The instrumentplatform is suitable for use in limited resource settings (e.g.,developing countries such as China and India) and newborn testingenvironments such as a maternity hospital or birthing center laboratory.

Enzyme Assays for Sanfilippo A (MPS IIIA) and B (MPS IIIB) Syndromes ona Droplet Actuator

The invention provides assay methods for detection of Sanfilippo A (MPSIIIA) and B (MPS IIIB) syndromes on a droplet actuator. Sanfilippo Asyndrome and Sanfilippo B syndrome are caused by deficient activity ofthe lysosomal enzymes heparan sulfate sulfamidase (SGSH) andalpha-N-acetylglucosaminidase (NAGLU), respectively. In one embodiment,the invention provides methods for a droplet-based enzymatic assay forheparan sulfate sulfamidase activity in a biological sample. The samplefor the enzymatic assay may, for example, be a dried blood extractdroplet. The droplet-based enzymatic assay for heparan sulfatesulfamidase activity may, for example, be performed at a pH of about 6.The substrate fluid for heparan sulfate sulfamidase in the enzymaticassay may, for example, be the fluorogenic substrate4-methylumbelliferyl-α-N-sulpho-D-glucosaminide (MU-αGlcNS; MoscerdamSubstrates). Generation of a fluorescent signal from the MU-αGlcNSsubstrate requires the activity of two enzymes, heparan sulfatesulfamidase and a supplemented second enzyme α-N-acetylglucosaminidase.In this assay, heparan sulfate sulfamidase first acts on the MU-αGlcNSsubstrate fluid to yield a 4-MU-αGlcNH₂ intermediate. The second enzymeα-N-acetylglucosaminidase acts on the 4-MU-αGlcNH₂ intermediate torelease 4-methylumbelliferyl (4-MU) generating a fluorescent signal. Inthe absence of heparan sulfate sulfamidase, the 4-MU-αGlcNH₂intermediate is not formed and no fluorescent signal is produced. In oneexample, the supplemented α-N-acetylglucosaminidase activity may beprovided by using yeast α-glucosidase. In another example, thesupplemented α-N-acetylglucosaminidase activity may be provided by usingrecombinant α-N-acetylglucosaminidase.

In another embodiment, the invention provides methods for adroplet-based one-step enzymatic assay for alpha-N-acetylglucosaminidase(NAGLU) activity in a biological sample. The sample for the enzymaticassay may, for example, be a dried blood extract droplet. The substratefluid for alpha-N-acetylglucosaminidase in the enzymatic assay may, forexample, be the fluorogenic substrate4-methylumbelliferyl-α-D-N-acetylglucosamine (Moscerdam Substrates).

Other embodiments may make use of the modified umbelliferyl substratesdescribed herein.

Enzyme Assays for Metachromatic Leukodystrophy (MLD) and Maroteaux-LamySyndrome (MPS VI) on a Droplet Actuator

The invention provides assay methods for detection of metachromaticleukodystrophy (MLD) and Maroteaux-Lamy syndrome on a droplet actuator.MLD and MPS VI are caused by deficient activity of the lysosomal enzymesarylsulfatase A and arylsulfatase B, respectively. Current bench-basedassays for determination of arylsulfatase A and arylsulfatase Bactivities may be described and implemented on a droplet actuator asdiscrete step-by-step droplet-based protocols. In one embodiment,protocols that use the colorimetric substrate p-nitrocatechol sulfate(PNCS; Sigma) may be adapted for use on a droplet actuator. In oneexample, a bench-based protocol that uses PNCS for detection ofarylsulfatase A activity may be adapted for use on a droplet actuator.In the bench-based assay, the assay buffer is 50 mM NaOAc, 0.5 M NaCl,pH 4.5. At a reaction temperature of 37° C., PNCS may be used as asubstrate for detection of both arylsulfatase A and arylsulfatase Bactivities. For specific detection of arylsulfatase A activity (i.e.,MLD), the enzymatic assay is performed at 0° C. Absorbance is read at516 nm. Translation of the bench-based protocol to a droplet-basedprotocol may, for example, include modifications in reaction components(e.g., assay buffer, pH, and reaction volumes) and incubation time. Thedroplet actuator may, for example, be configured for absorbance(colorimetric) detection. The droplet actuator may be designed to fitonto an instrument deck that houses extra-droplet actuator features suchas a cooling assembly (e.g., 0° C.) for performing arylsulfataseA-specific reactions (i.e., MLD) and a detection system for detection ofcolorimetric reaction products.

In another example, a bench-based protocol that uses PNCS for detectionof arylsulfatase B activity may be adapted for use on a dropletactuator. In the bench-based assay, the assay buffer is 50 mM MES, pH6.5. Absorbance is read at 516 nm. Translation of the bench-basedprotocol to a droplet-based protocol may, for example, includemodifications in reaction components (e.g., assay buffer, pH, andreaction volumes) and incubation time. The droplet actuator may, forexample, be configured for absorbance (colorimetric) detection. Thedroplet actuator may be designed to fit onto an instrument deck thathouses extra-droplet actuator features such as a detection system fordetection of colorimetric reaction products.

In another embodiment, a fluorogenic substrate such as3-O-sulfate-β-D-galactosyl-4-methylumbelliferyl may be used fordetection of arylsulfatase A activity (i.e., MLD). Generation of afluorescent signal from the3-O-sulfate-β-D-galactosyl-4-methylumbelliferyl substrate requires theactivity of two enzymes, arylsulfatase A and a supplemented secondenzyme β-galactosidase. In this assay, arylsulfatase A first acts on the3-O-sulfate-β-D-galactosyl-4-methylumbelliferyl substrate fluid to yielda 4-methylumbelliferyl-β-D-galactose intermediate. The second enzymeβ-galactosidase acts on 4-methylumbelliferyl-β-D-galactose to release4-methylumbelliferyl (4-MU) generating a fluorescent signal. In theabsence of arylsulfatase A, the 4-methylumbelliferyl-β-D-galactoseintermediate is not formed and no fluorescent signal is produced.Supplemental β-galactosidase may be selected such that the enzyme hassubstantially no activity on3-O-sulfate-β-D-galactosyl-4-methylumbelliferyl. In one example, thesupplemented β-galactosidase activity may be provided by using bovinetestis β-galactosidase. In another example, the supplementedβ-galactosidase activity may be provided by using humangalactocerebrosidase.

Sample

The enzyme assays of the invention make use of sample droplets andsubstrate droplets. Sample droplets are blood or blood-derived samples,such as plasma, serum, tissue, cell fractions, and treated,fractionated, concentrated and/or diluted forms of the foregoing. Forexample, diagnosis for Pompe disease is performed on fibroblasts. Otherbiological fluids may be used as samples; nonlimiting examples includetears, semen, urine, saliva, amniotic liquid and cerebrospinal fluid.For example, in the testing to diagnose Fabry disease, tears may be usedas the input sample droplet. Still other examples of biological fluidsare listed hereinbelow. Biological fluids may be treated as necessary toprepare them for being subjected to the protocols of the invention. Forexample, samples may be diluted or buffered, heated or cooled; pH may beadjusted; and/or blood samples may be treated with one or moreanticoagulants. Samples may be loaded into a reservoir associated with adroplet actuator, and may be dispensed into one or more subsamples. Insome cases, the subsamples are unit-sized subsamples. The subsamples maybe in contact with or surrounded with one or more filler fluids.

In one embodiment, the sample includes a reconstituted dried blood spot.Typically the subject's skin is pricked using a sterile puncture device,such as a lancet. Droplets of blood are spotted onto filter paper andallowed to dry. The filter paper may, for example, be a Whatman NeonatalScreening Card, such as the Whatman 903 Neonatal Blood Collection Card(available from GE Healthcare, Inc.). To reconstitute the dried bloodspots, a small disc is punched from the filter paper and placed insolution to yield a solution of reconstituted blood. The disc typicallyhas a diameter of about 3.2 mm, though other sizes may be used. Thereconstituted blood solution may be loaded onto a droplet actuator whereit is subject to droplet operations for conducting one or more assays.

In some embodiments, the disc may be punched directly into a dropletactuator reservoir, such as a reservoir situated in a droplet operationsgap and/or a reservoir which is external to the droplet operations gap.The external reservoir may be associated with a fluid passage suitablefor flowing reconstituted blood sample into the droplet operations gap.Fluid input reservoirs may be sized to accommodate a punch andreconstitution solution. In one embodiment, the well-to-well pitch is4.5 mm which is sufficient to fit a 3 mm DBS punch. Reservoirs may thusbe arranged to permit use of existing punchers, such as the Perkin-ElmerDBS Puncher™. Since the inner surfaces of the droplet operations gap arehydrophobic, the reconstitution solution, when added in to thereservoir, will remain in the reservoir. Liquid from the reservoircontaining the punch can be pulled into the droplet actuator throughelectric field to form droplets for subsequent enzymatic assays.Reservoirs may be associated with agitators or sonicators to effectmixing of the reconstituted samples. Any tendency of reconstitutedsample to flow into the droplet operations gap, e.g., during moving orshaking of the droplet actuator, may be reduced or minimized by loweringthe pressure of the liquid by configuring the reservoir to reduce theheight of the liquid column in the reservoir.

In some embodiments, a disc having a diameter of less than about 8 mm isreconstituted in less than about 1000 μL of solution, the sample isdispensed into at least 10 sub-droplets, and each sub-droplet is used toconduct a different enzyme assay. In other embodiments, a disc having adiameter of less than about 4 mm is reconstituted in less than about1000 μL of solution, the sample is dispensed into at least 10sub-droplets, and each sub-droplet is used to conduct a different enzymeassay. In some embodiments, a disc having a diameter of less than about8 mm is reconstituted in less than about 500 μL of solution, the sampleis dispensed into at least 10 sub-droplets, and each sub-droplet is usedto conduct a different enzyme assay. In some embodiments, a disc havinga diameter of less than about 4 mm is reconstituted in less than about500 μL of solution, the sample is dispensed into at least 10sub-droplets, and each sub-droplet is used to conduct a different enzymeassay. In other embodiments, a disc having a diameter of less than about8 mm is reconstituted in less than about 1000 μL of solution, the sampleis dispensed into at least 20 sub-droplets, and each sub-droplet is usedto conduct a different enzyme assay. In other embodiments, a disc havinga diameter of less than about 4 mm is reconstituted in less than about1000 μL of solution, the sample is dispensed into at least 20sub-droplets, and each sub-droplet is used to conduct a different enzymeassay. In some embodiments, a disc having a diameter of less than about8 mm is reconstituted in less than about 500 μL of solution, the sampleis dispensed into at least 20 sub-droplets, and each sub-droplet is usedto conduct a different enzyme assay. In some embodiments, a disc havinga diameter of less than about 4 mm is reconstituted in less than about500 μL of solution, the sample is dispensed into at least 20sub-droplets, and each sub-droplet is used to conduct a different enzymeassay. In some embodiments, a disc having a diameter of less than about8 mm is reconstituted in less than about 1000 μL of solution, the sampleis dispensed into at least 100 sub-droplets, and each sub-droplet isused to conduct a different enzyme assay. In other embodiments, a dischaving a diameter of less than about 4 mm is reconstituted in less thanabout 1000 μL of solution, the sample is dispensed into at least 100sub-droplets, and each sub-droplet is used to conduct a different enzymeassay. In some embodiments, a disc having a diameter of less than about8 mm is reconstituted in less than about 500 μL of solution, the sampleis dispensed into at least 100 sub-droplets, and each sub-droplet isused to conduct a different enzyme assay. In some embodiments, a dischaving a diameter of less than about 4 mm is reconstituted in less thanabout 500 μL of solution, the sample is dispensed into at least 100sub-droplets, and each sub-droplet is used to conduct a different enzymeassay. In some embodiments, a disc having a diameter of less than about8 mm is reconstituted in less than about 100 μL of solution, the sampleis dispensed into at least 20 sub-droplets, and each sub-droplet is usedto conduct a different enzyme assay. In some embodiments, a disc havinga diameter of less than about 4 mm is reconstituted in less than about100 μL of solution, the sample is dispensed into at least 20sub-droplets, and each sub-droplet is used to conduct a different enzymeassay. In some embodiments, a disc having a diameter of less than about8 mm is reconstituted in less than about 100 μL of solution, the sampleis dispensed into at least 100 sub-droplets, and each sub-droplet isused to conduct a different enzyme assay. In some embodiments, a dischaving a diameter of less than about 4 mm is reconstituted in less thanabout 100 μL of solution, the sample is dispensed into at least 100sub-droplets, and each sub-droplet is used to conduct a different enzymeassay.

In some cases, the droplet including an enzyme of interest is preparedby reconstituting a dried blood spot disc having a diameter of less thanabout 3 mm in less than about 200 μL of solution. The sample may, forexample, be dispensed into at least 10 sample droplets, and each sampledroplet is used to conduct a different enzyme assay. In anotherembodiment, the disc has a diameter of less than about 3 mm; the disk isreconstituted in less than about 200 μL of solution; the sample isdispensed into at least 5 sub-droplets; and at least 5 sub-droplets areeach used to conduct a different enzyme assay. In another embodiment,the disc has a diameter of less than about 6 mm; the disc isreconstituted in less than about 800 μL of solution; the sample isdispensed into at least 5 sub-droplets; and at least 5 sub-droplets areeach used to conduct a different enzyme assay. In another embodiment,the disc has a diameter of less than about 6 mm; the disc isreconstituted in less than about 800 μL of solution; the sample isdispensed into at least 5 sub-droplets; and at least 5 sub-droplets areeach used to conduct a different enzyme assay. In another embodiment,the disc has a diameter of less than about 3 mm; the disk isreconstituted in less than about 200 μL of solution; the sample isdispensed into at least 10 sub-droplets; and at least 10 sub-dropletsare each used to conduct a different enzyme assay. In anotherembodiment, the disc has a diameter of less than about 6 mm; the disc isreconstituted in less than about 800 μL of solution; the sample isdispensed into at least 10 sub-droplets; and at least 10 sub-dropletsare each used to conduct a different enzyme assay. In anotherembodiment, the disc has a diameter of less than about 6 mm; the disc isreconstituted in less than about 800 μL of solution; the sample isdispensed into at least 10 sub-droplets; and at least 10 sub-dropletsare each used to conduct a different enzyme assay. In anotherembodiment, the disc has a diameter ranging from about 1 mm to about 6mm; the disc is reconstituted in solution ranging from about 22 μL toabout 800 μL; the sample is dispensed into at least 5 sub-droplets; andat least 5 sub-droplets are each used to conduct a different enzymeassay.

In some cases, the volume of each of the sample and substrate dropletsused to conduct the enzyme assays of the invention may range from about1 nL to about 1000 μL; or about 1 nL to about 1000 nL; or about 1 nL toabout 500 nL; or about 1 nL to about 250 nL. Where a dried blood spot isused, the sample droplet is prepared by reconstituting a dried bloodspot disc. In some cases, the disc has a diameter of less than about 10mm and is reconstituted in less than about 1000 μL of solution; or lessthan about 750 μL of solution; or less than about 500 μL of solution; orless than about 250 μL of solution; or ranging from about 25 μL to about750 μL; or ranging from about 25 μL to about 500 μL; or ranging fromabout 25 μL to about 250 μL; or ranging from about 25 μL to about 150μL. In some cases, the sample is dispensed into at least 5 sampledroplets; or at least 10 sample droplets; or at least 25 sampledroplets; or at least 40 sample droplets. In some cases, the dried bloodspot disc has a diameter ranging from about 1 mm to about 10 mm; or fromabout 1 mm to about 8 mm; or from about 1 mm to about 6 mm; or fromabout 1 mm to about 4 mm.

In another aspect of the invention, fresh blood from a subject is usedto conduct the assays of the invention. In one aspect, less than about1.0 mL of blood is removed from a newborn. In another aspect, less thanabout 0.1 mL of blood is removed from a newborn. In another aspect, lessthan about 0.05 mL of blood is removed from a newborn. In anotheraspect, less than about 0.01 mL of blood is removed from a newborn. Theremoved blood may be deposited into a reservoir on a droplet actuator.In some cases a diluents and/or buffer droplet may be combined with thefresh blood sample. In some cases a droplet comprising an anticoagulantmay be combined with the fresh blood sample or an anticoagulant may bemixed with the sample droplet.

Systems

Fluorescence and absorbance detection may be performed on a singledroplet actuator, such as the droplet actuator device described inreference to FIG. 11. The path lengths for fluorescence detectionand/or, in some embodiments, absorbance detection, on a droplet actuatormay, for example, be about 300 μm. Because of the small path lengths, itmay be useful to reduce interference of hemoglobin in the DBS extract.For example, in an LSD testing assay, hemoglobin in a DBS extract doesnot substantially affect fluorescence at 365 nm. The droplet actuatordevice may be further adapted for increased detection sensitivity. Inone example, filler fluids may be selected to substantially minimizepartitioning of reaction products into the filler fluid. In anotherexample, substrate coatings on bottom and/or top substrates of thedroplet actuator may be selected to substantially minimize backgroundfluorescence. In addition, appropriate filters in aphotomultiplier-based detection system may be used to increase detectionsensitivity. In yet another example, because the assays are enzymatic,the substrate fluid may be added in excess to yield a better signal overa more prolonged period of time. In yet another example, additives suchas DMSO and other ionic surfactants may be added to increase thesolubility of the reaction products within the aqueous droplet.

The various aspects of the invention may be embodied as a method,system, computer readable medium, and/or computer program product.Aspects of the invention may take the form of hardware embodiments,software embodiments (including firmware, resident software, micro-code,etc.), or embodiments combining software and hardware aspects that mayall generally be referred to herein as a “circuit,” “module” or“system.” Furthermore, the methods of the invention may take the form ofa computer program product on a computer-usable storage medium havingcomputer-usable program code embodied in the medium.

Any suitable computer useable medium may be utilized for softwareaspects of the invention. The computer-usable or computer-readablemedium may be, for example but not limited to, an electronic, magnetic,optical, electromagnetic, infrared, or semiconductor system, apparatus,device, or propagation medium. The computer readable medium may includetransitory and/or non-transitory embodiments. More specific examples (anon-exhaustive list) of the computer-readable medium would include someor all of the following: an electrical connection having one or morewires, a portable computer diskette, a hard disk, a random access memory(RAM), a read-only memory (ROM), an erasable programmable read-onlymemory (EPROM or Flash memory), an optical fiber, a portable compactdisc read-only memory (CD-ROM), an optical storage device, atransmission medium such as those supporting the Internet or anintranet, or a magnetic storage device. Note that the computer-usable orcomputer-readable medium could even be paper or another suitable mediumupon which the program is printed, as the program can be electronicallycaptured, via, for instance, optical scanning of the paper or othermedium, then compiled, interpreted, or otherwise processed in a suitablemanner, if necessary, and then stored in a computer memory. In thecontext of this document, a computer-usable or computer-readable mediummay be any medium that can contain, store, communicate, propagate, ortransport the program for use by or in connection with the instructionexecution system, apparatus, or device.

Program code for carrying out operations of the invention may be writtenin an object oriented programming language such as Java, Smalltalk, C++or the like. However, the program code for carrying out operations ofthe invention may also be written in procedural programming languages,such as the “C” programming language or similar programming languages.The program code may be executed by a processor, application specificintegrated circuit (ASIC), or other component that executes the programcode. The program code may be simply referred to as a softwareapplication that is stored in memory (such as the computer readablemedium discussed above). The program code may cause the processor (orany processor-controlled device) to produce a graphical user interface(“GUI”). The graphical user interface may be visually produced on adisplay device, yet the graphical user interface may also have audiblefeatures. The program code, however, may operate in anyprocessor-controlled device, such as a computer, server, personaldigital assistant, phone, television, or any processor-controlled deviceutilizing the processor and/or a digital signal processor.

The program code may locally and/or remotely execute. The program code,for example, may be entirely or partially stored in local memory of theprocessor-controlled device. The program code, however, may also be atleast partially remotely stored, accessed, and downloaded to theprocessor-controlled device. A user's computer, for example, mayentirely execute the program code or only partly execute the programcode. The program code may be a stand-alone software package that is atleast partly on the user's computer and/or partly executed on a remotecomputer or entirely on a remote computer or server. In the latterscenario, the remote computer may be connected to the user's computerthrough a communications network.

The invention may be applied regardless of networking environment. Thecommunications network may be a cable network operating in theradio-frequency domain and/or the Internet Protocol (IP) domain. Thecommunications network, however, may also include a distributedcomputing network, such as the Internet (sometimes alternatively knownas the “World Wide Web”), an intranet, a local-area network (LAN),and/or a wide-area network (WAN). The communications network may includecoaxial cables, copper wires, fiber optic lines, and/or hybrid-coaxiallines. The communications network may even include wireless portionsutilizing any portion of the electromagnetic spectrum and any signalingstandard (such as the IEEE 802 family of standards, GSM/CDMA/TDMA or anycellular standard, and/or the ISM band). The communications network mayeven include powerline portions, in which signals are communicated viaelectrical wiring. The invention may be applied to any wireless/wirelinecommunications network, regardless of physical componentry, physicalconfiguration, or communications standard(s).

Certain aspects of invention are described with reference to variousmethods and method steps. It will be understood that each method stepcan be implemented by the program code and/or by machine instructions.The program code and/or the machine instructions may create means forimplementing the functions/acts specified in the methods.

The program code may also be stored in a computer-readable memory thatcan direct the processor, computer, or other programmable dataprocessing apparatus to function in a particular manner, such that theprogram code stored in the computer-readable memory produce or transforman article of manufacture including instruction means which implementvarious aspects of the method steps.

The program code may also be loaded onto a computer or otherprogrammable data processing apparatus to cause a series of operationalsteps to be performed to produce a processor/computer implementedprocess such that the program code provides steps for implementingvarious functions/acts specified in the methods of the invention.

CONCLUDING REMARKS

The foregoing detailed description of embodiments refers to theaccompanying drawings, which illustrate specific embodiments of theinvention. Other embodiments having different structures and operationsdo not depart from the scope of the present invention. The term “theinvention” or the like is used with reference to certain specificexamples of the many alternative aspects or embodiments of theapplicants' invention set forth in this specification, and neither itsuse nor its absence is intended to limit the scope of the applicants'invention or the scope of the claims. This specification is divided intosections for the convenience of the reader only. Headings should not beconstrued as limiting of the scope of the invention. The definitions areintended as a part of the description of the invention. It will beunderstood that various details of the present invention may be changedwithout departing from the scope of the present invention. Furthermore,the foregoing description is for the purpose of illustration only, andnot for the purpose of limitation.

I claim:
 1. An assay for acid β-galactosidase activity, comprising: (a)combining in oil a sample droplet with a4-methylumbelliferyl-B-galactose to yield a reaction droplet; (b)splitting the reaction droplet to yield a first daughter droplet and asecond daughter droplet; (c) combining the first daughter droplet with astop buffer droplet to yield a first stopped reaction droplet; (d)incubating the second daughter droplet; (e) combining the seconddaughter droplet with a stop buffer droplet to yield a second stoppedreaction droplet; and (f) measuring 4-methylumbelliferone released inthe first and second stopped reaction droplets; (g) correlating the4-methylumbelliferone measured in the first and second stopped reactiondroplets with the acid beta-galactosidase activity.
 2. The method ofclaim 1 wherein multiple assays for β-galactosidase activity areperformed in parallel.
 3. The method of claim 1 wherein the incubatingproceeds for a time which is less than about 24 hours.
 4. The method ofclaim 1 wherein the incubating proceeds for a time which is less thanabout 12 hours.
 5. The method of claim 1 wherein the incubating proceedsfor a time which is less than about 9 hours.
 6. The method of claim 1wherein the incubating proceeds for a time which is less than about 6hours.
 7. The method of claim 1 wherein the incubating proceeds for atime which is less than about 3 hours.
 8. The method of claim 1 whereinthe incubating proceeds at about room temperature.
 9. The method ofclaim 1 wherein the droplets are surrounded by oil.
 10. The method ofclaim 1 wherein the steps of the method are performed in dropletscontrolled by a droplet actuator.
 11. The method of claim 10 wherein thedroplet actuator controls the steps using electrode mediated dropletoperations.
 12. The method of claim 11 wherein the droplet actuatorcontrols the steps using electrowetting mediated droplet operations. 13.The method of claim 11 wherein the droplet actuator controls the stepsusing dielectrophoresis mediated droplet operations.
 14. The method ofclaim 1 wherein the sample comprises a blood sample.
 15. The method ofclaim 14 wherein the blood sample is prepared by a method including ananion reduction step.
 16. The method of claim 15 wherein the anionreduction step comprises a dilution step.
 17. The method of claim 15wherein the anion reduction step comprises a precipitation step.
 18. Themethod of claim 1 wherein the sample comprises a plasma sample.
 19. Themethod of claim 18 wherein the plasma sample is diluted from about 1:2to about 1:15 plasma:buffer.
 20. The method of claim 18 wherein theplasma sample is diluted from about 1:5 to about 1:10 plasma:buffer. 21.The method of claim 1 wherein the sample is a reconstituted dried bloodspot sample.
 22. The method of claim 21 wherein the reconstituted bloodsample is reconstituted from a dried blood spot using an extractionvolume ranging from about 25 to about 150 μL.
 23. The method of claim 21wherein the reconstituted blood sample is reconstituted from a driedblood spot using an extraction volume ranging from about 25 to about 100μL.
 24. The method of claim 21 wherein the reconstituted blood sample isreconstituted from a dried blood spot using an extraction volume rangingfrom about 25 to about 75 μL.
 25. The method of claim 21 wherein thereconstituted blood sample is reconstituted from a dried blood spotusing an extraction volume ranging from about 40 to about 60 μL.
 26. Themethod of claim 21 wherein the reconstituted blood sample isreconstituted from a dried blood spot using a buffer doped withsurfactant.
 27. The method of claim 26 wherein the surfactant comprisesa polysorbate surfactant.
 28. The method of claim 1, further comprisingquantifying released 4-methylumbelliferone or an analog or derivativethereof.
 29. The method of claim 1 wherein the reaction is performed ata temperature ranging from about 25 to about 40° C.
 30. The method ofclaim 1 wherein the reaction is performed at a temperature ranging fromabout 30 to about 40° C.
 31. The method of claim 1 wherein the reactionis performed at a temperature ranging from about 36 to about 39° C.